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NPI Code Detail

MEDICARE: CAROLINA GALLEGOS

MEDICARE: CAROLINA GALLEGOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1366989048
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINA GALLEGOS
Provider Business Mailing Address
First Line : 7226 SEPULVEDA BLVD
Second Line :
City : VAN NUYS
State : CA
Zip : 91405-2003
Country : US
Telephone Number : 818-235-1414
Fax Number : 818-945-0827
Provider Business Practice Location Address
First Line : 7226 SEPULVEDA BLVD
Second Line :
City : VAN NUYS
State : CA
Zip : 91405-2003
Country : US
Telephone Number : 818-235-1414
Fax Number : 818-945-0827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2017
Last Update Date : 01/19/2017

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Directions to “ CAROLINA GALLEGOS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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