Individual
CARLY CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4388 KATELLA AVE, LOS ALAMITOS, CA 90720-3565
(562) 596-0050
Mailing address
1901 E 1ST ST APT 155, SANTA ANA, CA 92705-4038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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