Provider Demographics
NPI:1689462145
Name:CABALLERO, ANGELA DANITA RAYANN (HOME CARE AID)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DANITA RAYANN
Last Name:CABALLERO
Suffix:
Gender:
Credentials:HOME CARE AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 NE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-7928
Mailing Address - Country:US
Mailing Address - Phone:360-706-8837
Mailing Address - Fax:
Practice Address - Street 1:14913 SE MILL PLAIN BLVD APT E31
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8245
Practice Address - Country:US
Practice Address - Phone:470-758-5798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60937444376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide