Provider Demographics
NPI:1669925475
Name:STRAUGHN, CAMELIA (DBA)
Entity type:Individual
Prefix:DR
First Name:CAMELIA
Middle Name:
Last Name:STRAUGHN
Suffix:
Gender:F
Credentials:DBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-4826
Mailing Address - Country:US
Mailing Address - Phone:916-239-5561
Mailing Address - Fax:
Practice Address - Street 1:1951 67TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4826
Practice Address - Country:US
Practice Address - Phone:916-239-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist