Provider Demographics
NPI:1912994823
Name:MCCALMONT, VICKI LYNN (MS, NP)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:LYNN
Last Name:MCCALMONT
Suffix:
Gender:F
Credentials:MS, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14691 CHAPARRAL SLOPE RD
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-3300
Mailing Address - Country:US
Mailing Address - Phone:619-669-7663
Mailing Address - Fax:619-669-7663
Practice Address - Street 1:7901 FROST ST
Practice Address - Street 2:SHARP MEMORIAL HEART TRANSPLANT DEPARTMENT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2701
Practice Address - Country:US
Practice Address - Phone:858-939-3831
Practice Address - Fax:858-939-4547
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11951363LA2100X, 363LA2200X
CA1369364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist