Provider Demographics
NPI:1184253924
Name:CALDERON, PATRICIA (RN, DCES)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:RN, DCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N. FRESNO STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701
Mailing Address - Country:US
Mailing Address - Phone:559-459-1763
Mailing Address - Fax:559-459-1034
Practice Address - Street 1:215 N. FRESNO STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701
Practice Address - Country:US
Practice Address - Phone:559-459-1763
Practice Address - Fax:559-459-1034
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429431163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator