Provider Demographics
NPI:1720317167
Name:CABALLERO, MARIA SYLVIA (PTA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SYLVIA
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:CRUZ
Other - Last Name:CABALLERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:8901 GLADBECK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324
Mailing Address - Country:US
Mailing Address - Phone:818-472-9927
Mailing Address - Fax:818-998-3890
Practice Address - Street 1:8901 GLADBECK AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3908
Practice Address - Country:US
Practice Address - Phone:818-472-9927
Practice Address - Fax:818-998-3890
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT8505225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant