=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518821776
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES ANDREW CALVERT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 EUREKA RD
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-3027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-784-4050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 FERRY CIR # 34
-----------------------------------------------------
City | FOLSOM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95630-4011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-317-7107
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2278G1100X
-----------------------------------------------------
Taxonomy Name | General Care Certified Respiratory Therapist
-----------------------------------------------------
License Number | 2278G1100X
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------