Healthcare Provider Details

I. General information

NPI: 1760395933
Provider Name (Legal Business Name): CANDY ITXEL CALDERON ORTIZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17702 SIERRA HWY
SANTA CLARITA CA
91351
US

IV. Provider business mailing address

37359 CAMBRIDGE LN
PALMDALE CA
93550-6276
US

V. Phone/Fax

Practice location:
  • Phone: 888-770-9269
  • Fax:
Mailing address:
  • Phone: 661-403-7840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: