Provider Demographics
NPI:1578639415
Name:GEORGE CABALLERO, LCSW INC
Entity Type:Organization
Organization Name:GEORGE CABALLERO, LCSW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CABALLERO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:323-255-9421
Mailing Address - Street 1:P.O. BOX 411141
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041
Mailing Address - Country:US
Mailing Address - Phone:323-255-9421
Mailing Address - Fax:323-344-9084
Practice Address - Street 1:516 W WHITTIER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-5234
Practice Address - Country:US
Practice Address - Phone:323-255-9421
Practice Address - Fax:323-344-9084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS115221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 11522OtherLICENSED SOCIAL WORKER
CAR36980Medicare ID - Type Unspecified