Carol Lynn Camarillo, PSYD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY 22641 Issued in CA

Practice address

100 Prison Rd
Represa, CA 95671-3000

Phone

(916) 985-8610

Fax

(916) 294-3066

NPI assigned

Jun 30, 2009

Last updated

Jun 30, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corrections and Rehabilitation-Headquarters

  dba California State Prison-Sacramento

  • Pharmacy
  • Represa, CA
  • NPI 1154953529
  NPD (past)

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1912135807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7211",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956217211",
            "telephone_number": "916-985-8610",
            "fax_number": "916-294-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRISON RD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956713000",
            "telephone_number": "916-985-8610",
            "fax_number": "916-294-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY 22641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Bentley, TEACHING, PSYCH ASST
• Carrie L Brecker, PSYD
• Brittany T. Brizendine, PSY.D.
• Lindsey Bryden, LCSW
• Nicole Calma, PSY.D.
• Jacqueline Daasch Caoile, PHD
• Isidro Acosta Cardeno, M.D.
• Adielle Carrington, PSY.D.
• Meg Eu Cho, ED.D.
• Stephen Joseph Clavere, PH.D.

• Forensic Psychologist in Represa, CA
• Providers in Represa, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.