Provider Demographics
NPI:1992907653
Name:CAMMARANO, VIRGINIA CAROL (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:CAROL
Last Name:CAMMARANO
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MRS
Other - First Name:GINNY
Other - Middle Name:CAROL
Other - Last Name:CAMMARANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LMFT
Mailing Address - Street 1:29353 HIDDEN OAK PL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-5907
Mailing Address - Country:US
Mailing Address - Phone:661-755-6969
Mailing Address - Fax:
Practice Address - Street 1:23030 LYONS AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2752
Practice Address - Country:US
Practice Address - Phone:661-755-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT144059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist