Provider Demographics
NPI:1932364262
Name:CALZADA, NANCY (LVN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CALZADA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:SAMBRANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:9462 VAN NUYS BLVD.
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402
Mailing Address - Country:US
Mailing Address - Phone:818-891-8555
Mailing Address - Fax:818-891-8649
Practice Address - Street 1:9462 VAN NUYS BLVD
Practice Address - Street 2:WESTERN PACIFIC PANORAMA MED CORP
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-891-8555
Practice Address - Fax:818-891-8649
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAVN202603164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)