Provider Demographics
NPI:1427354067
Name:CABALLERO, SAMANTHA IRINA (BACHELORS)
Entity type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:IRINA
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:MRS
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:GANADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BACHELORS/QMHA
Mailing Address - Street 1:5466 SPANISH MOSS DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-2660
Mailing Address - Country:US
Mailing Address - Phone:775-232-3446
Mailing Address - Fax:775-626-2874
Practice Address - Street 1:5466 SPANISH MOSS DR
Practice Address - Street 2:2419 CAPRIOLATE DRIVE
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-2660
Practice Address - Country:US
Practice Address - Phone:775-232-3446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-30
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider