Provider Demographics
NPI:1427391879
Name:CALVILLO, ALMA CECILIA
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:CECILIA
Last Name:CALVILLO
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 1:2275 E. COOLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324
Mailing Address - Country:US
Mailing Address - Phone:424-610-0366
Mailing Address - Fax:
Practice Address - Street 1:2275 E. COOLEY DRIVE
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3932
Practice Address - Country:US
Practice Address - Phone:424-610-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN249966164X00000X, 373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse