Healthcare Provider Details

I. General information

NPI: 1588236483
Provider Name (Legal Business Name): JANELY CALDERON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S ELLSWORTH AVE
SAN MATEO CA
94401-3939
US

IV. Provider business mailing address

1200 RICKABAUGH WAY UNIT 539
SANTA CLARA CA
95050-3153
US

V. Phone/Fax

Practice location:
  • Phone: 415-362-2901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU3644
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: