Individual
CAMILLE CELESTE ROCHA-WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2769 VALENCIA RD, APTOS, CA 95003-9616
(831) 889-8100
Mailing address
2769 VALENCIA RD, APTOS, CA 95003-9616
(831) 889-8100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/01/2019
Last updated
03/10/2021
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