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Mr. John Joseph Pangallo, SUDRC
Addiction (Substance Use Disorder) Counselor in Kings Beach, California
NPI 1568653905

John Joseph Pangallo is an Addiction (Substance Use Disorder) Counselor based in Kings Beach, CA and is specialized in Addiction (Substance Use Disorder). John Joseph Pangallo practices in Kings Beach, CA and has the professional credentials of SUDRC. The NPI Number for John Joseph Pangallo is 1568653905 and holds a License No. (California).

The current practice location address for John Joseph Pangallo is 8491 North Lake Blvd, Kings Beach, CA and can be reached out via phone at 530-546-5641.

Location: 8491 North Lake Blvd, Kings Beach, CA, 96143-2099
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568653905
Provider Name
John Joseph Pangallo
Credential
SUDRC
Provider Entity Type
Individual
Gender
Male
Address
8491 North Lake Blvd, Kings Beach, CA, 96143-2099
Phone Number
530-546-5641
Fax Number
Provider Enumeration Date
08/08/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8491 North Lake Blvd
City
Kings Beach
State
California
Zip
96143
Phone Number
530-546-5641
Fax Number
person
Provider Business Mailing Address Details
Address
8491 North Lake Blvd
City
Kings Beach
State
California
Zip
96143
Phone Number
530-546-5641
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
9579 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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