Provider Demographics
NPI:1194042994
Name:CALDERON, ESMERALDA HIDALGO
Entity Type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:HIDALGO
Last Name:CALDERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 S VERMONT AVE
Mailing Address - Street 2:SUITE L102
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1029
Mailing Address - Country:US
Mailing Address - Phone:310-323-6887
Mailing Address - Fax:310-436-8289
Practice Address - Street 1:19401 S VERMONT AVE
Practice Address - Street 2:SUITE L102
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1029
Practice Address - Country:US
Practice Address - Phone:310-323-6887
Practice Address - Fax:310-436-8289
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59725106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist