Healthcare Provider Details

I. General information

NPI: 1780523605
Provider Name (Legal Business Name): LIUGIE CABALLERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17555 VENTURA BLVD
ENCINO CA
91316-3890
US

IV. Provider business mailing address

27223 CLOVERHURST PL
CANYON COUNTRY CA
91387-3803
US

V. Phone/Fax

Practice location:
  • Phone: 818-305-1952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: