Provider Demographics
NPI:1841495454
Name:CAMACHO, AILEEN (MD)
Entity type:Individual
Prefix:DR
First Name:AILEEN
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AILEEN
Other - Middle Name:
Other - Last Name:CAMACHO VILLAMIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6991 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-9629
Mailing Address - Country:US
Mailing Address - Phone:707-485-5115
Mailing Address - Fax:
Practice Address - Street 1:CONSOLIDATED TRIBAL HEALTH
Practice Address - Street 2:6991 N. STATE ST.
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-9629
Practice Address - Country:US
Practice Address - Phone:707-485-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0190412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry