Provider Demographics
NPI:1497405369
Name:VAIZ, CALEB ALEJANDRO (NONE)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:ALEJANDRO
Last Name:VAIZ
Suffix:
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N B ST STE D
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-0326
Mailing Address - Country:US
Mailing Address - Phone:916-370-8266
Mailing Address - Fax:
Practice Address - Street 1:1103 N B ST STE D
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-0326
Practice Address - Country:US
Practice Address - Phone:916-370-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician