Active NPI
Jaime A Calderon, PSYCHOLOGIST
- School Psychologist
- Longwood, FL
National Provider Identifier
1366726770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS 674
- Practice address
- 555 Estates PL
Longwood, FL 32779-2857 - Phone
- (407) 862-7305
- NPI assigned
- Oct 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | SS674 | FL | |
| School Psychologist | 103TS0200X | SS 674 | FL | Primary |
Addresses
Primary practice location
555 Estates PL
Longwood, FL 32779-2857
Mailing address
555 Estates PL
Longwood, FL 32779-2857
Phone (407) 862-7305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS674 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1366726770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 ESTATES PL",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327792857",
"telephone_number": "407-862-7305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 ESTATES PL",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327792857",
"telephone_number": "407-862-7305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "JAIME",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-04",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "SS674",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS 674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.