Provider Demographics
NPI:1164196523
Name:CALDWELL, CALIFORNIA LENEE (RN, MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CALIFORNIA
Middle Name:LENEE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10463 ASHCAKE RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7629
Mailing Address - Country:US
Mailing Address - Phone:804-819-9939
Mailing Address - Fax:
Practice Address - Street 1:8100 THREE CHOPT RD RM 127
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4800
Practice Address - Country:US
Practice Address - Phone:434-466-1588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00241823292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry