Provider Demographics
NPI:1972840569
Name:CAIOZZO, CAMILLE (PHD)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:CAIOZZO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 W RIVERSIDE DR STE 305
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4048
Mailing Address - Country:US
Mailing Address - Phone:818-846-9501
Mailing Address - Fax:818-273-1041
Practice Address - Street 1:4444 W RIVERSIDE DR STE 305
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4048
Practice Address - Country:US
Practice Address - Phone:818-846-9501
Practice Address - Fax:818-273-1041
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8751103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral