Camille Black

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

127823 Issued in CA

Practice address

5284 Adolfo Rd
Camarillo, CA 93012-6787

Phone

(805) 289-0120

NPI assigned

Jul 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Engage You, Inc

  • Psychologist
  • Westlake Village, CA
  • NPI 1558101568
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  NPD
• Black Girls Mental Health Collective, a Family Therapy Prof. Corp.

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1073383220

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1083137467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19153",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913199153",
            "telephone_number": "805-795-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5284 ADOLFO RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930126787",
            "telephone_number": "805-289-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "97114",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASPIRANET",
            "identifier": "56CC",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Billings
• Shannon Rachel Billings, CF-SLP
• Bio-Medical Applications of Camarillo, Inc. (Camarillo Dialysis Center)
• Sara Birjani
• Amy Bisogni, OTR/L, CNT, IBCLC
• Blake Health Management Inc
• Darren Michael Blatt, MA, MFT-I
• Blendwise Nutrition
• Gwendolyn Sheila Bleu, AMFT
• Christopher Blum

• Marriage & Family Therapist in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.