Healthcare Provider Details

I. General information

NPI: 1811207426
Provider Name (Legal Business Name): NICOLE CALMA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PRISON ROAD SACRAMENTO STATE PRISON
REPRESA CA
95671
US

IV. Provider business mailing address

100 PRISON ROAD SACRAMENTO STATE PRISON
REPRESA CA
95671
US

V. Phone/Fax

Practice location:
  • Phone: 916-985-8610
  • Fax:
Mailing address:
  • Phone: 916-985-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number29969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: