Healthcare Provider Details
I. General information
NPI: 1831027713
Provider Name (Legal Business Name): CALDR DISABILITY ADVOCATE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 H ST # B
SACRAMENTO CA
95816-4416
US
IV. Provider business mailing address
3020 H ST # B
SACRAMENTO CA
95816-4416
US
V. Phone/Fax
- Phone: 916-472-9031
- Fax:
- Phone: 916-472-9031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171R00000X |
| Taxonomy | Interpreter |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171WH0202X |
| Taxonomy | Home Modifications Contractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOISEY
KELBATYROV
Title or Position: ORGANIZATION DIRECTOR
Credential:
Phone: 916-472-9031