Provider Demographics
NPI:1588894844
Name:CAMU, JASON NICHOLAS (PSYD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:NICHOLAS
Last Name:CAMU
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 EL CAMINO REAL
Mailing Address - Street 2:SUITE 2B-1
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8508
Mailing Address - Country:US
Mailing Address - Phone:760-828-3835
Mailing Address - Fax:
Practice Address - Street 1:7720 EL CAMINO REAL
Practice Address - Street 2:SUITE 2B-1
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8508
Practice Address - Country:US
Practice Address - Phone:760-828-3835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17682103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist