Provider Demographics
NPI:1205537677
Name:CALLE, ROSE (MFT)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:CALLE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18951 KITTRIDGE ST UNIT 86
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5988
Mailing Address - Country:US
Mailing Address - Phone:818-665-6390
Mailing Address - Fax:
Practice Address - Street 1:18951 KITTRIDGE ST UNIT 86
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5988
Practice Address - Country:US
Practice Address - Phone:818-665-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist