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General NPI Number Information
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NPI Number | 1851275465
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Entity Type | Individual
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Provider Name | JOHN CHATTEN CARUSO
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Gender | Male
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 844 PICO BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405-1325
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Country | US
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Telephone | 310-314-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 5159 VERONICA ST
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City | LOS ANGELES
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State | CA
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Zip | 90008-1122
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Country | US
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Telephone | 310-384-6352
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1502590323
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License Number State | CA
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