Provider Demographics
NPI:1144471509
Name:BURNETT, CAMERON LOVELL (MSW)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:LOVELL
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9227 HAVEN AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5420
Mailing Address - Country:US
Mailing Address - Phone:909-989-5699
Mailing Address - Fax:
Practice Address - Street 1:9227 HAVEN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5420
Practice Address - Country:US
Practice Address - Phone:909-989-5699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical