Provider Demographics
NPI:1306719661
Name:PAULO, CAMERON
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:PAULO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 LEWELLING BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94580-1632
Mailing Address - Country:US
Mailing Address - Phone:341-202-0989
Mailing Address - Fax:510-901-7863
Practice Address - Street 1:268 LEWELLING BLVD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:CA
Practice Address - Zip Code:94580-1632
Practice Address - Country:US
Practice Address - Phone:341-202-0989
Practice Address - Fax:510-901-7863
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01246951376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide