Provider Demographics
NPI:1952457764
Name:PARKER, CAMILLE M (LVN)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:M
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:364 KRALIK ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-8006
Mailing Address - Country:US
Mailing Address - Phone:619-715-0759
Mailing Address - Fax:
Practice Address - Street 1:364 KRALIK ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-8006
Practice Address - Country:US
Practice Address - Phone:619-715-0759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223846164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse