Provider Demographics
NPI:1922331859
Name:MACRORIE, KAMERON VALERE (MS, MFT)
Entity type:Individual
Prefix:MRS
First Name:KAMERON
Middle Name:VALERE
Last Name:MACRORIE
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7426 CHERRY AVE. STE 210 #419
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336
Mailing Address - Country:US
Mailing Address - Phone:951-415-0641
Mailing Address - Fax:
Practice Address - Street 1:915 W IMPERIAL HWY STE 150
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3854
Practice Address - Country:US
Practice Address - Phone:800-998-6329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist