Provider Demographics
NPI:1023882685
Name:KALDAS, MARIAN Y
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:Y
Last Name:KALDAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28140 TAMBORA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-1261
Mailing Address - Country:US
Mailing Address - Phone:661-755-4033
Mailing Address - Fax:
Practice Address - Street 1:76 BEACH ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3801
Practice Address - Country:US
Practice Address - Phone:661-755-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health