Provider Demographics
NPI:1780360404
Name:CABALLERO, MARIA CATALINA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CATALINA
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BERRINGER ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1142
Mailing Address - Country:US
Mailing Address - Phone:915-861-4147
Mailing Address - Fax:
Practice Address - Street 1:1035 BELVIDERE ST STE 123
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2433
Practice Address - Country:US
Practice Address - Phone:915-642-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5938103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst