Provider Demographics
NPI:1700437522
Name:CALDERON, GEORGINA (RN, DNP)
Entity type:Individual
Prefix:MRS
First Name:GEORGINA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:RN, DNP
Other - Prefix:DR
Other - First Name:GEORGINA
Other - Middle Name:
Other - Last Name:CALDERON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR CALDERON, DNP
Mailing Address - Street 1:2137 JODY AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2434
Mailing Address - Country:US
Mailing Address - Phone:714-673-0044
Mailing Address - Fax:
Practice Address - Street 1:661 W 1ST ST STE G
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2939
Practice Address - Country:US
Practice Address - Phone:714-665-9890
Practice Address - Fax:714-665-9891
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012593363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology