Provider Demographics
NPI:1457239303
Name:CALVILLO, GINA MARIA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIA
Last Name:CALVILLO
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 1:851 PALO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-5425
Mailing Address - Country:US
Mailing Address - Phone:760-590-7365
Mailing Address - Fax:
Practice Address - Street 1:851 PALO VERDE DR
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-5425
Practice Address - Country:US
Practice Address - Phone:760-590-7365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker