Basic Information
Provider Information
NPI: 1508210592
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMAYA
FirstName: CLAIRE
MiddleName: ANNE ANICETE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ANICETE
OtherFirstName: CLAIRE
OtherMiddleName: ANNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 1411 E 31ST ST
Address2: 2ND FLR A2
City: OAKLAND
State: CA
PostalCode: 946021018
CountryCode: US
TelephoneNumber: 5104375039
FaxNumber: 5105357313
Practice Location
Address1: 1411 E 31ST ST
Address2: 2ND FLR A2
City: OAKLAND
State: CA
PostalCode: 946021018
CountryCode: US
TelephoneNumber: 5104375039
FaxNumber: 5105357313
Other Information
ProviderEnumerationDate: 04/16/2016
LastUpdateDate: 01/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home