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General NPI Number Information
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NPI Number | 1033602750
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Entity Type | Individual
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Provider Name | ISAMAR MAYOL CALDERON MA
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Gender | Female
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 02/02/2025
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Provider Practice Location Address
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Address Line | 8500 FALMOUTH AVE UNIT 3106
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-8760
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Country | US
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Telephone | 787-565-1270
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Fax |
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Provider Business Mailing Address
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Address Line | 1576 N WARREN AVE APT 311
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City | MILWAUKEE
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State | WI
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Zip | 53202-2242
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Country | US
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Telephone | 787-565-1270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 32360
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License Number State | CA
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