Mr. John Joseph Pangallo, SUDRC

Individual provider Rehabilitation Practitioner · NPI 1568653905

Mr. John Joseph Pangallo, SUDRC is a Rehabilitation Practitioner in Kings Beach, California. Practices as a sole proprietor and works from 3 locations. Licensed in California.

Licensed in: CA
In the registry since: 2007
Specialties on file: 2

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Practice location Address checks out

8491 N Lake Blvd
Kings Beach, CA 96143
Phone: (530) 546-5641

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

555 Hospital Ln, Susanville, CA 96130-4808 — (530) 251-8108
10015 Palisades Dr Ste 1, Truckee, CA 96161-1941 — (530) 587-8194

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary)	Taxonomy 101YA0400X · Licence 9579 (CA)
Rehabilitation Practitioner	Taxonomy 225400000X

Record details

NPI number	1568653905
Entity type	Individual (Type 1)
Gender	Male
Credentials	SUDRC
Sole proprietor	Yes
NPI enumerated	August 8, 2007
Last updated in NPPES	September 18, 2019