Provider Demographics
NPI:1811755903
Name:ALTOMARE, CALI
Entity type:Individual
Prefix:
First Name:CALI
Middle Name:
Last Name:ALTOMARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CALI
Other - Middle Name:
Other - Last Name:MIKOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2639
Mailing Address - Country:US
Mailing Address - Phone:614-722-2000
Mailing Address - Fax:
Practice Address - Street 1:495 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5679
Practice Address - Country:US
Practice Address - Phone:614-355-7150
Practice Address - Fax:614-355-7855
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2506563-TRNE390200000X
172V00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor