Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033760061 |
---|---|
Provider Name | Caroline Caballero |
First Address | Napa, CA 94558-6216 |
Second Address | Napa, CA 94558-6216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2019 |
Last Update Date | 20/09/2019 |