Provider Demographics
NPI:1720316870
Name:VEGA, CAMILLE SUN
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:SUN
Last Name:VEGA
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 1:1665 OLD HOT SPRINGS RD
Mailing Address - Street 2:STE 157
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0782
Mailing Address - Country:US
Mailing Address - Phone:775-687-5162
Mailing Address - Fax:
Practice Address - Street 1:3595 US HIGHWAY 50
Practice Address - Street 2:SUITE 3
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429-9613
Practice Address - Country:US
Practice Address - Phone:775-577-0319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health