Provider Demographics
NPI:1184268088
Name:CABALLERO, DANA (LCSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27762 ANTONIO PKWY # L1-235
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1140
Mailing Address - Country:US
Mailing Address - Phone:949-484-5279
Mailing Address - Fax:
Practice Address - Street 1:30240 RACHO VIEJO RD
Practice Address - Street 2:SUITE C-1
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675
Practice Address - Country:US
Practice Address - Phone:949-484-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA168361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical