Provider Demographics
NPI:1982885109
Name:CAMERON, ANNE MARIE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16458 BOLSA CHICA ST
Mailing Address - Street 2:#321
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2603
Mailing Address - Country:US
Mailing Address - Phone:714-471-9751
Mailing Address - Fax:
Practice Address - Street 1:3855 E LA PALMA AVE
Practice Address - Street 2:115
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1729
Practice Address - Country:US
Practice Address - Phone:714-471-9751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41737106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist