Provider Demographics
NPI:1285212423
Name:CALDERON, DIANA ELENA (MFT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:ELENA
Last Name:CALDERON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 TOURNEY RD UNIT 175
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4990
Mailing Address - Country:US
Mailing Address - Phone:661-705-4670
Mailing Address - Fax:
Practice Address - Street 1:27200 TOURNEY RD UNIT 175
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4990
Practice Address - Country:US
Practice Address - Phone:661-705-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CAAMFT142693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician