Maria De la Luz Camacho, RDA

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

RDA90299 Issued in CA

Practice address

4200 N Lakewood Blvd
Long Beach, CA 90808-1558

Phone

(562) 420-1701

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1033675350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 FLALLON AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906501621",
            "telephone_number": "562-277-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 N LAKEWOOD BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081558",
            "telephone_number": "562-420-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "MARIA",
        "middle_name": "DE LA LUZ",
        "name_prefix": "Ms.",
        "credential": "RDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA90299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RDA90299",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie Camacho
• Graciela Camacho, LVN
• Kaitlyn Camacho
• Kambria Virginia Camacho
• Lauren Camacho, SLPA
• Leah Camara
• Veronica Camarero, LCSW
• Helena Camargo
• Dara Justine Almodiel Camarillo, BA, MSOT, OTR/L
• Cambodian Association of America

• Dental Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Dental Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.