Provider Demographics
NPI:1558543082
Name:MACALOLOOY, PHILLIP CHARLES (CADCII SUDCC III-CS)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:CHARLES
Last Name:MACALOLOOY
Suffix:
Gender:M
Credentials:CADCII SUDCC III-CS
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 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:598-366-5545
Mailing Address - Fax:
Practice Address - Street 1:3300 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3137
Practice Address - Country:US
Practice Address - Phone:559-836-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)