Provider Demographics
NPI:1326885617
Name:CALHOUN, ROCHELLE JOHNNIE (CMT)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:JOHNNIE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:JOHNNIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:24085 BLACKBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-8989
Mailing Address - Country:US
Mailing Address - Phone:530-332-0867
Mailing Address - Fax:
Practice Address - Street 1:421 ANTELOPE BLVD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2402
Practice Address - Country:US
Practice Address - Phone:530-332-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91473225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist