Provider Demographics
NPI:1811719842
Name:CALDERON, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CALDERON
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 EUBANK AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-3786
Mailing Address - Country:US
Mailing Address - Phone:310-872-8158
Mailing Address - Fax:
Practice Address - Street 1:3010 E VICTORIA ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-5617
Practice Address - Country:US
Practice Address - Phone:213-549-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator