Provider Demographics
NPI:1891990875
Name:CALDERON, NORMA BEATRIZ
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:BEATRIZ
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 1:12 W BEACH ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4504
Mailing Address - Country:US
Mailing Address - Phone:831-763-8958
Mailing Address - Fax:
Practice Address - Street 1:12 W BEACH ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4504
Practice Address - Country:US
Practice Address - Phone:831-763-8958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC6657202OtherDRIVER'S LICENSE #