Individual
EARL BANAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 ALABAMA ST, VALLEJO, CA 94590-4446
(707) 515-7186
Mailing address
508 ALABAMA ST, VALLEJO, CA 94590-4446
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/28/2020
Last updated
07/11/2025
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