Provider Demographics
NPI:1134832702
Name:CAMPOS, VANESSA RITA (ASW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:RITA
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SUTTER ST
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3504
Mailing Address - Country:US
Mailing Address - Phone:530-673-9420
Mailing Address - Fax:530-740-5187
Practice Address - Street 1:1000 SUTTER ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3504
Practice Address - Country:US
Practice Address - Phone:530-673-9420
Practice Address - Fax:530-740-5187
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1128661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical