Basic Information
Provider Information
NPI: 1174532667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: CAMILLE
MiddleName: YOUNG
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10470 OLD PLACERVILLE RD
Address2: SUITE 100
City: SACRAMENTO
State: CA
PostalCode: 958272539
CountryCode: US
TelephoneNumber: 8004700071
FaxNumber:  
Practice Location
Address1: 770 MASON ST
Address2:  
City: VACAVILLE
State: CA
PostalCode: 956884646
CountryCode: US
TelephoneNumber: 7074274900
FaxNumber: 7074545831
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 07/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XA110083CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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