CAMERON PARK COUNSELING CENTER — NPI 1093104325 (Licensed & Credentialed Point of Service in CAMERON PARK, CA)

CMS-1500 Box 24J / 33a • NPI

1093104325

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

305S00000X

Licensed & Credentialed Point of Service

Box 32 Service Location & ZIP+4

3294 ROYAL DR STE 13, CAMERON PARK, CA, 95682-8500

✓ 9-Digit EDI 837 ZIP+4 (95682-8500)

Practice Phone & Referral Fax

(530) 677-4404

Fax: (530) 677-4545

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1093104325 (CAMERON PARK COUNSELING CENTER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1093104325` (NPI-2 Organization / Facility)
Provider / Legal Name	CAMERON PARK COUNSELING CENTER
Plain-English Specialty	Licensed & Credentialed Point of Service NUCC Code: `305S00000X` (Point of Service)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3294 ROYAL DR STE 13, CAMERON PARK, CA, 95682-8500
Practice Telephone / Fax	Tel: (530) 677-4404 \| Fax: (530) 677-4545
Administrative Mailing Address	3294 ROYAL DR STE 13, CAMERON PARK, CA, 95682-8500
Enumeration & Last Sync	Enumerated: 2015-01-09 \| CMS Record Updated: 2015-01-09
Authorized Official	MARIA NIETO (Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3294 ROYAL DR STE 13, CAMERON PARK, CA, 95682-8500

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Plain-English Taxonomy & CMS Crosswalk (305S00000X)

What Does Taxonomy Code 305S00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 305S00000X translates to:
"Licensed & Credentialed Point of Service"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Point of Service for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CAMERON PARK COUNSELING CENTER)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`305S00000X` — Point of Service Plain English: Licensed & Credentialed Point of Service	State: CA \| License: `PSY 6138` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CAMERON PARK COUNSELING CENTER (NPI #1093104325)