Provider Demographics
NPI:1730173865
Name:CALANDRA, JOAN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:CALANDRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11340 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1608
Mailing Address - Country:US
Mailing Address - Phone:310-433-7723
Mailing Address - Fax:310-207-2506
Practice Address - Street 1:11340 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1608
Practice Address - Country:US
Practice Address - Phone:310-243-5343
Practice Address - Fax:310-836-9920
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-05
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18529103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist