Individual
DR. DIANA CALDERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1801 SEVENTH STREET, LAS VEGAS, NM 87701
(505) 454-9758
(505) 454-9755
Mailing address
PO BOX 1868, LAS VEGAS, NM 87701
(505) 454-9758
(505) 454-9755
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
583
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N7805
—
NM
01
—
NM100157
VALUE OPTIONS
NM
Enumeration date
03/01/2007
Last updated
07/08/2007
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