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NPI Code Detail

MEDICARE: EVELYN PRISCILLA CALDERON

MEDICARE: EVELYN PRISCILLA CALDERON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1568296853
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN PRISCILLA CALDERON
Provider Business Mailing Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 310-804-4023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2024
Last Update Date : 12/01/2025

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Directions to “ EVELYN PRISCILLA CALDERON ” Practice Location

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