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General NPI Number Information
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NPI Number | 1295066561
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Entity Type | Individual
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Provider Name | STEPHANIE CABALLES
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 555 NORTHGATE DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-491-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 HARDER ROAD #723A
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City | HAYWARD
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State | CA
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Zip | 94542
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Country | US
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Telephone | 858-722-4494
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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