Healthcare Provider Details

I. General information

NPI: 1902453384
Provider Name (Legal Business Name): LAURA CABALLERO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W. VICTORIA STE F & G
COMPTON CA
90220
US

IV. Provider business mailing address

PO BOX 41003
DOWNEY CA
90239-2003
US

V. Phone/Fax

Practice location:
  • Phone: 310-669-9510
  • Fax: 310-669-9501
Mailing address:
  • Phone: 562-441-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number117717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: