Provider Demographics
NPI:1447605696
Name:YOUNG, CAMILLE LORRAINE
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:LORRAINE
Last Name:YOUNG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N RINE ST
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101-3941
Mailing Address - Country:US
Mailing Address - Phone:530-518-5488
Mailing Address - Fax:
Practice Address - Street 1:701 N MAIN ST STE E2
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3493
Practice Address - Country:US
Practice Address - Phone:302-335-7405
Practice Address - Fax:530-233-1902
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68394101YM0800X
CA861291041C0700X
CALCSW861291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health