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General NPI Number Information
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NPI Number | 1275892960
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Entity Type | Individual
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Provider Name | MARIA CARMEN CALDERON MA
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 1250 AVE PONCE DE LEON SAN JOSE BLDG. SUITE 501
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City | SANTURCE
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State | PR
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Zip | 00907-3949
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Country | US
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Telephone | 787-753-0937
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Fax |
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Provider Business Mailing Address
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Address Line | PARQ DE TORRIMAR H-7 CALLE 5
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City | BAYAMON
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State | PR
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Zip | 00959-8943
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Country | US
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Telephone | 787-790-1133
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 622
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License Number State | PR
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