Provider Demographics
NPI:1548445844
Name:CAMERINO, NELS WILLIAM
Entity type:Individual
Prefix:MR
First Name:NELS
Middle Name:WILLIAM
Last Name:CAMERINO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:NELS
Other - Middle Name:WILLIAM
Other - Last Name:CAMERINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11751 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3440
Mailing Address - Country:US
Mailing Address - Phone:714-934-3041
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-5957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3053225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist