Provider Demographics
NPI: | 1487302709 |
---|---|
Name: | HOUGH, CAMERON |
Entity type: | Individual |
Prefix: | |
First Name: | CAMERON |
Middle Name: | |
Last Name: | HOUGH |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4025 W 226TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | TORRANCE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90505-2340 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-373-4556 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4025 W 226TH ST |
Practice Address - Street 2: | |
Practice Address - City: | TORRANCE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90505-2340 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-373-4556 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2022-03-15 |
Last Update Date: | 2025-09-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 225400000X | |
171M00000X, 373H00000X, 172V00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist | |
No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 172V00000X | Other Service Providers | Community Health Worker |