Provider Demographics
NPI:1871321349
Name:CALDERON-ZACHARIU, GABRIELA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:CALDERON-ZACHARIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23029 NE ARATA RD APT 3
Mailing Address - Street 2:
Mailing Address - City:WOOD VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2754
Mailing Address - Country:US
Mailing Address - Phone:619-636-4555
Mailing Address - Fax:
Practice Address - Street 1:23029 NE ARATA RD APT 3
Practice Address - Street 2:
Practice Address - City:WOOD VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97060-2754
Practice Address - Country:US
Practice Address - Phone:619-636-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist