Pamela Marie Campbell, MFT INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

85859 Issued in CA

Practice address

1545 St. Mark'S Plaza #5
Stockton, CA 95207

Phone

(209) 470-2946

Fax

(209) 955-1050

NPI assigned

Aug 3, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 21, 2024 through Oct 21, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Vance Marriage and Family Therapy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stockton, CA
  • NPI 1144716549
  NPD (past)

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1447506878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ST. MARK'S PLAZA #5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-470-2946",
            "fax_number": "209-955-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ST. MARK'S PLAZA #5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-470-2946",
            "fax_number": "209-955-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "PAMELA",
        "middle_name": "MARIE",
        "credential": "MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "66111",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Camarillo
• Bena Tak Yee Chan Camello
• Robert C Camp
• Angelica Corrine Marie Campbell
• Chavelle Campbell
• Tabitha Trelaine Campbell
• Monique Marie Campero
• Jessica Campos-Ruiz
• Cecilia Anna Campos
• Lydia Campos

• Marriage & Family Therapist in Stockton, CA
• Providers in Stockton, 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 Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.