SERGIO L CACCIOTTI (NPI# 1932757416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932757416 |
| Entity Type | Individual |
| Full Name | SERGIO L CACCIOTTI |
| Practice Address |
204 Hampton Dr Venice CA 90291-2623 |
| Mailing Address |
3120 4th St Santa Monica CA 90405-5471 |
| Practice Telephone | 3103966468 |
| Mailing Telephone | 3105703769 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
CA | Behavioral Health & Social Service Providers | |
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
204 HAMPTON DR |
| City | VENICE |
| State | CA |
| Zip Code | 90291-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265569545 | Joaquin Ortega | Rehabilitation Practitioner | 204 Hampton Dr, Dept 3100, Venice, CA 90291-2623 | 2007-02-27 |
| 1972104412 | Keira Armstrong | Student in an Organized Health Care Education/Training Program | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-11-02 |
| 1588261614 | Joel Perez Jr. | Student in an Organized Health Care Education/Training Program | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-10-01 |
| 1194332189 | Jessica Dian Bryant | Student in an Organized Health Care Education/Training Program | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-09-24 |
| 1841804135 | Jonathon Vorpe | Counselor | 204 Hampton Dr, Venice, CA 90291-8633 | 2020-09-03 |
| 1730792540 | Austin Michael Martinez | Counselor | 204 Hampton Dr, Venice, CA 90291-8633 | 2020-08-31 |
| 1396354288 | Efren Espinoza | Case Manager/Care Coordinator | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-07-27 |
| 1831717917 | Carla A Gonzalez | Case Manager/Care Coordinator | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-07-06 |
| 1164049540 | Alicia Crooks | Case Manager/Care Coordinator | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-07-01 |
| 1437776341 | Kristen Elizabeth Nichols | Counselor | 204 Hampton Dr, Venice, CA 90291-2623 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629837 | Dylan Booth | Dentist | 601 Vernon Ave, Venice, CA 90291 | 2017-10-05 |
| 1467979500 | Linda Sittler | Registered Nurse | 1025 Palms Ave, Venice, CA 90291 | 2017-08-29 |
| 1003218660 | Patricia Guadalupe Rivas | Counselor | 717 Lincoln Blvd., Venice, CA 90291 | 2014-09-25 |
| 1497016877 | Carrie Lynn Kowalski | Physician Assistant | 604 Rose Avenue, Venice, CA 90291 | 2012-06-02 |
| 1821364761 | Cheryl Lynn Perkins | Nutritionist | 215 Culver Boulevard, # 5203, Playa Del Rey, CA 90291 | 2012-03-26 |
| 1629391875 | James L. Hoff | Optometrist | 1636 Abbot Kinney Blvd., Venice, CA 90291 | 2010-03-02 |
| 1720315096 | Kristen Nicol Leishman | Counselor | 911 Coeur D'alene Ave, Venice, CA 90291 | 2009-11-06 |
| 1922237882 | David Anthony Garcia | Physician Assistant | 15031 Rinaldi St., Providence Holy Cross Medical Center Ed, Mission Hills, CA 90291 | 2009-07-13 |
| 1548411010 | David Watts | Acupuncturist | 307 S. Robertson Blvd, Beverly Hills, CA 90291 | 2008-10-02 |
| 1184891699 | Judy Alexander | Voluntary or Charitable | 204 Hampton Drive, St Joseph Center, Venice, CA 90291 | 2008-05-14 |
| Find all providers in zip 90291 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265569545 | Joaquin Ortega | Rehabilitation Practitioner | 204 Hampton Dr, Dept 3100, Venice, CA 90291-2623 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
| 1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
| 1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
| 1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
| 1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
| 1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.