Provider Demographics
NPI:1174896377
Name:CAMARA, CARINE JAMILA (LAC)
Entity type:Individual
Prefix:
First Name:CARINE
Middle Name:JAMILA
Last Name:CAMARA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 DEWING AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4246
Mailing Address - Country:US
Mailing Address - Phone:925-310-5317
Mailing Address - Fax:
Practice Address - Street 1:936 DEWING AVE STE B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4246
Practice Address - Country:US
Practice Address - Phone:925-310-5317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14296171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist