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Individual

JESSICA CALDERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MST

Contact information

Practice address
1621 SUTTER PLACE, CLOVIS, NM 88101
(575) 742-2620
(575) 742-3182
Mailing address
1100 W. 21ST, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
01369101
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
L7904
NM
Enumeration date
09/09/2009
Last updated
03/17/2015
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