Provider Demographics
NPI:1194426338
Name:CALDERON SANTANA, XIARA
Entity type:Individual
Prefix:
First Name:XIARA
Middle Name:
Last Name:CALDERON SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2900
Mailing Address - Country:US
Mailing Address - Phone:978-601-1383
Mailing Address - Fax:
Practice Address - Street 1:55 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2900
Practice Address - Country:US
Practice Address - Phone:978-601-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician