Healthcare Provider Details

I. General information

NPI: 1609632918
Provider Name (Legal Business Name): CALLAH CAOILE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 VALLE VERDE DR
NAPA CA
94558-2414
US

IV. Provider business mailing address

3419 VALLE VERDE DR
NAPA CA
94558-2414
US

V. Phone/Fax

Practice location:
  • Phone: 707-299-8215
  • Fax: 707-635-8215
Mailing address:
  • Phone: 707-299-8215
  • Fax: 707-635-8215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: