Provider Demographics
NPI:1871488080
Name:CALDERON, JOSHUA (AMFT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 S BENTLEY AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4325
Mailing Address - Country:US
Mailing Address - Phone:310-409-8717
Mailing Address - Fax:
Practice Address - Street 1:1835 S BENTLEY AVE APT 20
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4325
Practice Address - Country:US
Practice Address - Phone:310-409-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153202101200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist