Provider Demographics
NPI:1881464899
Name:CAMARILLO, MARY ANN (NBC-HWC)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:CAMARILLO
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:CAMARILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NBC-HWC
Mailing Address - Street 1:114 CASSIN CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8044
Mailing Address - Country:US
Mailing Address - Phone:805-479-5459
Mailing Address - Fax:
Practice Address - Street 1:114 CASSIN CT
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8044
Practice Address - Country:US
Practice Address - Phone:805-479-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach