Casey Caccam

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

95163263 Issued in CA

Practice address

14850 Roscoe Blvd
Panorama City, CA 91402-4618

Phone

(818) 904-3122

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1477197903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 ROWLAND AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633050",
            "telephone_number": "805-657-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14850 ROSCOE BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024618",
            "telephone_number": "818-904-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCAM",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95163263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "95136263",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ccaccam@mchonline.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "14850 Roscoe Blvd",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914024618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rodion Butyrski
• Kevin Lee Caballa, RCP
• Kimberly Joy Dacquel Cabanting
• Benjamin Cabrera
• Gopal Cabrera, DC
• Cal Burke
• Timothy J Calams, AUD
• Douglas L. Caldwell, MD
• Sibylle Theresia Ramsey Caldwell, M.S.
• Calhoun Congregate Living (United Care Center)

• Adult Psychiatric/Mental Health Registered Nurse in Panorama City, CA
• Providers in Panorama City, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.