Provider Demographics
NPI:1013588987
Name:CALVILLO CHAVIRA, EVA I (CSW)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:I
Last Name:CALVILLO CHAVIRA
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:CALVILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSW
Mailing Address - Street 1:796 E PACIFIC DR STE A
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3161
Mailing Address - Country:US
Mailing Address - Phone:801-642-2491
Mailing Address - Fax:801-216-4566
Practice Address - Street 1:796 E PACIFIC DR STE A
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3161
Practice Address - Country:US
Practice Address - Phone:801-642-2491
Practice Address - Fax:801-216-4566
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5246767-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical