Healthcare Provider Details

I. General information

NPI: 1437015245
Provider Name (Legal Business Name): CALEB NAMOWICZ AMFT/APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 12/28/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 MAGNOLIA AVE # A
BREA CA
92821-6554
US

IV. Provider business mailing address

514 MAGNOLIA AVE # A
BREA CA
92821-6554
US

V. Phone/Fax

Practice location:
  • Phone: 619-705-7590
  • Fax:
Mailing address:
  • Phone: 619-705-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: