Provider Demographics
NPI:1457122871
Name:HERSHEY, CAMERON (RN)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27701 COUNTRY LANE RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27701 COUNTRY LANE RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3775
Practice Address - Country:US
Practice Address - Phone:909-635-8861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95109657163W00000X, 163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight
No163W00000XNursing Service ProvidersRegistered Nurse