Provider Demographics
NPI:1568657211
Name:CALIXTO, PETER-REUBEN BAAY (RN, BSN, CNN)
Entity Type:Individual
Prefix:
First Name:PETER-REUBEN
Middle Name:BAAY
Last Name:CALIXTO
Suffix:
Gender:M
Credentials:RN, BSN, CNN
Other - Prefix:
Other - First Name:PEDRO-REUBEN
Other - Middle Name:BAAY
Other - Last Name:CALIXTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN BSN CNN
Mailing Address - Street 1:151 LINDA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1604
Mailing Address - Country:US
Mailing Address - Phone:414-468-7995
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN325537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse