Basic Information
| Provider Information | |||||||||
| NPI: | 1679718605 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALDERON | ||||||||
| FirstName: | OFELIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | BSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 W COMMERCE ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782073839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109220103 | ||||||||
| FaxNumber: | 2109220162 | ||||||||
| Practice Location | |||||||||
| Address1: | 7404 HWY 90 W | ||||||||
| Address2: | BUILDING 37 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782274024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106456612 | ||||||||
| FaxNumber: | 2106746364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2008 | ||||||||
| LastUpdateDate: | 12/04/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.