Provider Demographics
NPI:1881996601
Name:CAMERON, JENNIFER JONES (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JONES
Last Name:CAMERON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 SIX FORKS RD STE 207
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3094
Mailing Address - Country:US
Mailing Address - Phone:919-245-7791
Mailing Address - Fax:
Practice Address - Street 1:8303 SIX FORKS RD STE 207
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3094
Practice Address - Country:US
Practice Address - Phone:919-245-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004153103TC0700X
NC5962103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical