Healthcare Provider Details

I. General information

NPI: 1598682080
Provider Name (Legal Business Name): MR. JAY CALINGACION DACATIMBANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30700 TELEGRAPH RD STE 2540
BINGHAM FARMS MI
48025-4526
US

IV. Provider business mailing address

30700 TELEGRAPH RD STE 2540
BINGHAM FARMS MI
48025-4526
US

V. Phone/Fax

Practice location:
  • Phone: 586-237-9390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704373209
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: