Provider Demographics
NPI:1144358532
Name:CAMERON, PAM ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:PAM
Middle Name:ELIZABETH
Last Name:CAMERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAM
Other - Middle Name:ELIZABETH
Other - Last Name:LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:116 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2412
Mailing Address - Country:US
Mailing Address - Phone:510-653-4592
Mailing Address - Fax:510-653-4592
Practice Address - Street 1:UNIVERSITY HEALTH SERVCICES 2222 BANCROFT WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-4300
Practice Address - Country:US
Practice Address - Phone:510-643-9169
Practice Address - Fax:510-643-5079
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily