Provider Demographics
NPI:1972300572
Name:CALDERON, ASTRID
Entity type:Individual
Prefix:
First Name:ASTRID
Middle Name:
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 1:366 S SIERRA MADRE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5231
Mailing Address - Country:US
Mailing Address - Phone:626-394-7183
Mailing Address - Fax:
Practice Address - Street 1:14600 SHERMAN WAY STE 100D
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-5869
Practice Address - Country:US
Practice Address - Phone:818-901-4854
Practice Address - Fax:818-908-4995
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner