Provider Demographics
NPI:1134468119
Name:CALKIN, DOUGLAS MCLENNAN JR
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MCLENNAN
Last Name:CALKIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NAPA VALLEJO HWY
Mailing Address - Street 2:BLDG. 253 M1 AND M2
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6234
Mailing Address - Country:US
Mailing Address - Phone:707-257-7395
Mailing Address - Fax:707-257-7524
Practice Address - Street 1:2100 NAPA VALLEJO HWY
Practice Address - Street 2:BLDG. 253 M1 AND M2
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6234
Practice Address - Country:US
Practice Address - Phone:707-257-7395
Practice Address - Fax:707-257-7524
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)