Individual provider Active NPI

George Caballero, MSW, LCSW

  • Clinical Social Worker
  • Montebello, CA
National Provider Identifier
1053413351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS11522 Issued in CA
Practice address
111 W Beverly Blvd
Suite 209
Montebello, CA 90640-4312
Phone
(323) 255-9421
Fax
(323) 344-9084
NPI assigned
Sep 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS11522 CA Primary

Addresses

Primary practice location

111 W Beverly Blvd
Suite 209
Montebello, CA 90640-4312

Mailing address

P.O. Box 411141
Los Angeles, CA 90041
Phone (323) 255-9421

Other identifiers 1

IdentifierTypeStateIssuer
LCS 11522OtherCALICENSED SOCIAL WORKER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080522000718 CA Practitioner - Clinical Social Worker 5799854220 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11522CAMDClinical Psychologist
LCS11522CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
George Caballero, LCSW Inc Clinical CurrentSince Nov 1, 2024 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients

Locations

1611 Paramount Blvd
Montebello, CA 90640
Phone (323) 255-9421

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053413351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 411141",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90041",
            "telephone_number": "323-255-9421",
            "fax_number": "323-344-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W BEVERLY BLVD",
            "address_2": "SUITE 209",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404312",
            "telephone_number": "323-255-9421",
            "fax_number": "323-344-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "GEORGE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED SOCIAL WORKER",
            "identifier": "LCS 11522",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.