Provider Demographics
NPI:1407643042
Name:CALDERON, ROSA MARIA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:CALDERON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 SE ASHLEY PL
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-3239
Mailing Address - Country:US
Mailing Address - Phone:541-787-1507
Mailing Address - Fax:
Practice Address - Street 1:1060 SE ASHLEY PL
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3239
Practice Address - Country:US
Practice Address - Phone:541-787-1507
Practice Address - Fax:541-787-1507
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR26521225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist