Individual
MR. CAMERON CHRISTOPHER FONACIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20723 WALNUT VALLEY DR, WALNUT, CA 91789-1024
(909) 595-7448
Mailing address
20723 WALNUT VALLEY DR, WALNUT, CA 91789-1024
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
126516
CA
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
—
—
225C00000X
Rehabilitation Counselor
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2020
Last updated
10/15/2024
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