| Cameron Park Counseling Center, Inc. | |
|
970 Camerado Dr Ste 200 Cameron Park CA 95682-7636 | |
| (530) 677-4404 | |
| (530) 677-4545 |
| Full Name | Cameron Park Counseling Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 970 Camerado Dr Ste 200, Cameron Park, California |
| Authorized Official Name and Position | Rose-marie Y Nieto (OWNER, CLINICAL DIRECTOR) |
| Authorized Official Contact | 5306774404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cameron Park Counseling Center, Inc. 970 Camerado Dr Ste 200 Cameron Park CA 95682-7636 Ph: (530) 677-4404 | Cameron Park Counseling Center, Inc. 970 Camerado Dr Ste 200 Cameron Park CA 95682-7636 Ph: (530) 677-4404 |
| NPI Number | 1477760874 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 03/07/2023 |
| Certification Date | 03/07/2023 |
| Medicare PECOS PAC ID | 2163556531 |
|---|---|
| Medicare Enrollment ID | O20100820000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477760874 | NPI | - | NPPES |
| Provider Name | Frank J Nieto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144439746 PECOS PAC ID: 9537119342 Enrollment ID: I20050129000147 |
| Provider Name | Clarence R Hilliard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508804808 PECOS PAC ID: 4385655182 Enrollment ID: I20060614000181 |
| Provider Name | Rose-marie Y Nieto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366671257 PECOS PAC ID: 3476687856 Enrollment ID: I20100825000819 |
| Provider Name | Shama Chaiken |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003042763 PECOS PAC ID: 8224311774 Enrollment ID: I20170208001364 |
| Provider Name | Shelly Sue Goscha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750711719 PECOS PAC ID: 8820219108 Enrollment ID: I20180124000828 |
| Provider Name | Dorene M Fanning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831523711 PECOS PAC ID: 0345663274 Enrollment ID: I20210312001825 |
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