Provider Demographics
NPI:1134327638
Name:CAMPBELL, WILLEMIJN JOHANNA (MS)
Entity type:Individual
Prefix:MRS
First Name:WILLEMIJN
Middle Name:JOHANNA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25124 NARBONNE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2140
Mailing Address - Country:US
Mailing Address - Phone:888-286-8715
Mailing Address - Fax:888-286-8715
Practice Address - Street 1:25124 NARBONNE AVE STE 10290
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2142
Practice Address - Country:US
Practice Address - Phone:882-868-7158
Practice Address - Fax:888-286-8715
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12499103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW0101543OtherMEDICAL