Individual
CAMILLE DAWN SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. BCBA
Contact information
Practice address
474 BLOSSOM HILL RD, SAN JOSE, CA 95123-3301
(408) 826-4828
Mailing address
474 BLOSSOM HILL RD, SAN JOSE, CA 95123-3301
(831) 464-8798
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11415334
CA
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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