Provider Demographics
NPI:1841529039
Name:CAMPTON, RAYMOND S
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:S
Last Name:CAMPTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 DOMINGO AVE
Mailing Address - Street 2:SUITE #203
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2400
Mailing Address - Country:US
Mailing Address - Phone:925-746-7053
Mailing Address - Fax:
Practice Address - Street 1:2920 DOMINGO AVE
Practice Address - Street 2:SUITE #203
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2400
Practice Address - Country:US
Practice Address - Phone:925-746-7053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24746106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist