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JOHN TITO CABALLERO ACSW
>> Rehabilitation Practitioner >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1962922740
Individual Registrant: JOHN TITO CABALLERO ACSW
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
18623 GALE AVE CITY OF INDUSTRY, CA 91748 US
Tel: 626-389-0300 Fax: --
Tel: 626-389-0300 Fax: --
Contact information for business:
18623 GALE AVE CITY OF INDUSTRY, CA 91748-1342 US
Tel: 626-389-0300 Fax: --
Tel: 626-389-0300 Fax: --
Registration Information:
NPI: 1962922740
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Rehabilitation Practitioner | CA | |
| N | 390200000X | Student Organized Health Care Education/Training Program | CA | |
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor | CA | 84609 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1962922740 | CA | 05 |
