Individual provider Active NPI

Camille Bulaclac, LCSW

  • Clinical Social Worker
  • Santa Clara, CA
National Provider Identifier
1255975546
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121323 Issued in CA
Practice address
5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140
Phone
(323) 205-7088
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121323 CA Primary
Mental Health Counselor 101YM0800X
School Social Worker 1041S0200X

Addresses

Primary practice location

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Mailing address

22295 Torino
Laguna Hills, CA 92653-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1255975546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22295 TORINO",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULACLAC",
        "first_name": "CAMILLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121323",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.