Healthcare Provider Details

I. General information

NPI: 1750219267
Provider Name (Legal Business Name): MR. ISAIAH GRAEME CALDERON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 LITCHFIELD LN
CORRALITOS CA
95076-0628
US

IV. Provider business mailing address

250 LITCHFIELD LN
CORRALITOS CA
95076-0628
US

V. Phone/Fax

Practice location:
  • Phone: 831-537-7426
  • Fax:
Mailing address:
  • Phone: 831-537-7426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: