Active NPI
Anthony Camacam
- Adult Psychiatric/Mental Health Registered Nurse
- Redwood City, CA
National Provider Identifier
1124787932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 95233649
- Practice address
- 200 Edmonds Rd
Redwood City, CA 94062-3813 - Phone
- (650) 367-1890
- NPI assigned
- Dec 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 95233649 | CA | Primary |
Addresses
Primary practice location
200 Edmonds Rd
Redwood City, CA 94062-3813
Mailing address
200 Edmonds Rd
Redwood City, CA 94062-3813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95233649 | Other | CA | CORDILLERAS MHRC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95233649 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639008000000",
"number": "1124787932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 EDMONDS RD",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940623813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 EDMONDS RD",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940623813",
"telephone_number": "650-367-1890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACAM",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-09",
"last_updated": "2021-12-09",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "CA",
"license": "95233649",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORDILLERAS MHRC",
"identifier": "95233649",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.