=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083553234
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELINA MARIE CALVILLO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2026
-----------------------------------------------------
Last Update Date | 03/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1830 NOGALES ST
-----------------------------------------------------
City | ROWLAND HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91748-2945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-965-2541
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12551 ARLINGTON PL
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-6207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-825-9667
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 33160
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------