Provider Information for 1164878211
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NICOLE CALVENTO LMFT
Sex: Female
NPI: 1164878211
Last Updated: 2019-03-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164878211 | ||||||||
| Enumeration Date | 2016-05-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 10646 ZELZAH AVE STE 207 GRANADA HILLS, CA 91344-5959 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 8330 RESEDA BLVD NORTHRIDGE, CA 91324-4619 United States Phone: 818-534-1820 | Fax: | ||||||||
| Secondary Practice Address(es) | 10646 ZELZAH AVE STE 207 | ||||||||
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