Provider Demographics
NPI:1912118548
Name:CALDERON, ALBERT RICHARD I
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:RICHARD
Last Name:CALDERON
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2057 VANCOUVER AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5907
Mailing Address - Country:US
Mailing Address - Phone:323-269-1317
Mailing Address - Fax:
Practice Address - Street 1:15229 AMAR RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-2066
Practice Address - Country:US
Practice Address - Phone:818-855-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)