Provider Demographics
NPI:1427485366
Name:CAMP, STEVEN JAMES (BCBA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:CAMP
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 KENWOOD PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8876
Mailing Address - Country:US
Mailing Address - Phone:760-217-9678
Mailing Address - Fax:909-899-3059
Practice Address - Street 1:7527 KENWOOD PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-8876
Practice Address - Country:US
Practice Address - Phone:760-217-9678
Practice Address - Fax:909-899-3059
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-10
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-14004103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst