Provider Demographics
NPI:1821411034
Name:CALDERON, KAMILIA E
Entity Type:Individual
Prefix:MISS
First Name:KAMILIA
Middle Name:E
Last Name:CALDERON
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 1:1340 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:OUTLOOK
Mailing Address - State:WA
Mailing Address - Zip Code:98938-9771
Mailing Address - Country:US
Mailing Address - Phone:509-574-3271
Mailing Address - Fax:
Practice Address - Street 1:918 E MEAD AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-3720
Practice Address - Country:US
Practice Address - Phone:509-453-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst