Provider Demographics
NPI:1679393722
Name:CAMPBELL, ERIN (ACSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 233176
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-0436
Mailing Address - Country:US
Mailing Address - Phone:916-956-6755
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 233176
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-0436
Practice Address - Country:US
Practice Address - Phone:916-956-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124234104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker