Provider Demographics
NPI:1871724336
Name:CALTAGIRONE, NANCY (MA)
Entity type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:
Last Name:CALTAGIRONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 W MAIN ST
Mailing Address - Street 2:STE 200 I
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7723
Mailing Address - Country:US
Mailing Address - Phone:714-241-8400
Mailing Address - Fax:
Practice Address - Street 1:242 W MAIN ST
Practice Address - Street 2:STE 200 I
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7723
Practice Address - Country:US
Practice Address - Phone:714-241-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47142106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist