Provider Demographics
NPI:1669716445
Name:CALDERON, JILL (PHD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 SKY EXCHANGE DR APT 307
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0365
Mailing Address - Country:US
Mailing Address - Phone:845-480-0460
Mailing Address - Fax:
Practice Address - Street 1:83 SKY EXCHANGE DR APT 307
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-0365
Practice Address - Country:US
Practice Address - Phone:845-480-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6549103TC1900X
SC1803103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling