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Individual

CAMERON GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2525 W WASHINGTON BLVD # 104, LOS ANGELES, CA 90018-1247
(831) 917-8910
Mailing address
1821 W 42ND ST, LOS ANGELES, CA 90062-1529

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
93080
CA

Other

Enumeration date
07/19/2019
Last updated
11/23/2022
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