Active NPI
Camille T. Fine, PH.D.
- Clinical Child & Adolescent Psychologist
- Clearwater, FL
National Provider Identifier
1336421353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PY5786
- Practice address
- 13575 58TH St N
Suite 107
Clearwater, FL 33760-3740 - Phone
- (727) 742-7319
- NPI assigned
- Sep 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY5786 | FL | Primary |
Addresses
Primary practice location
13575 58TH St N
Suite 107
Clearwater, FL 33760-3740
Mailing address
13575 58TH St N
Suite 107
Clearwater, FL 33760-3740
Phone (727) 742-7319
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY5786 | FL | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1336421353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13575 58TH ST N",
"address_2": "SUITE 107",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337603740",
"telephone_number": "727-742-7319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13575 58TH ST N",
"address_2": "SUITE 107",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337603740",
"telephone_number": "727-742-7319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINE",
"first_name": "CAMILLE",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "FL",
"license": "PY5786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.