Provider Demographics
NPI:1437677622
Name:CALIXTE, VALERIE ANNA (INTERN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANNA
Last Name:CALIXTE
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 W 26TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-5239
Mailing Address - Country:US
Mailing Address - Phone:310-519-0418
Mailing Address - Fax:
Practice Address - Street 1:12440 FIRESTONE BLVD STE 3025
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-9331
Practice Address - Country:US
Practice Address - Phone:562-929-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program