Individual
ALAN JAMES CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
9479 HAVEN AVE, RANCHO CUCAMONGA, CA 91730-5844
(909) 771-8023
(909) 658-8977
Mailing address
621 CASA DE LEON, REDLANDS, CA 92373-5787
(909) 435-5787
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95053159
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95022516
CA
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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