Provider Demographics
NPI:1679171870
Name:MATTHEWS, CAMERON (BCBA)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:X
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 PIEDMONT AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5202
Mailing Address - Country:US
Mailing Address - Phone:619-988-8288
Mailing Address - Fax:
Practice Address - Street 1:4021 PIEDMONT AVE APT 5
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5202
Practice Address - Country:US
Practice Address - Phone:619-988-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-80739103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst