Provider Demographics
NPI:1851549554
Name:CALICA, ANNE
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:CALICA
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 1:5225 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4113
Mailing Address - Country:US
Mailing Address - Phone:805-765-6493
Mailing Address - Fax:805-765-6490
Practice Address - Street 1:5225 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4113
Practice Address - Country:US
Practice Address - Phone:805-765-6493
Practice Address - Fax:805-765-6490
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA238418164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)