| Doctor Name: | DR. MATTHEW GRANT CALKINS |
| NPI Number: | 1023212453 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY 21783 |
| Business Practice Address: | 1000 Fremont Ave Suite 212 South Pasadena, CA - 910303225 |
| Business Phone Number: | 2135955832 |
| Business Fax Number: | |
| Mailing Address: | 1000 Fremont Ave Ste 212, SOUTH PASADENA |
| State: | CA |
| Postal Code: | 910303225 |
| Phone Number: | 2135955832 |
| Fax Number: | |
| NPI Enumeration Date: | 06/11/2007 |
| NPI Last Update Date: | 02/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 21783 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |