Provider Demographics
NPI:1780287540
Name:CALDERON, BRIDGETTE GUADALUPE (ACSW)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:GUADALUPE
Last Name:CALDERON
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:BRIDGETTE
Other - Middle Name:GUADALUPE
Other - Last Name:JARAMILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9441
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92427-0441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 E MILL ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1604
Practice Address - Country:US
Practice Address - Phone:818-717-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical