Provider Demographics
NPI:1558546689
Name:MARGARITA CALZADILLA-KISHIMOTO
Entity Type:Organization
Organization Name:MARGARITA CALZADILLA-KISHIMOTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALZADILLA-KISHIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:714-309-9035
Mailing Address - Street 1:1517 W CRIS PL
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-2508
Mailing Address - Country:US
Mailing Address - Phone:714-309-9035
Mailing Address - Fax:714-558-6199
Practice Address - Street 1:1633 E 4TH ST
Practice Address - Street 2:SUITE 184
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5163
Practice Address - Country:US
Practice Address - Phone:714-309-9035
Practice Address - Fax:714-558-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN