Healthcare Provider Details

I. General information

NPI: 1154491835
Provider Name (Legal Business Name): CATHERINE HELEN CASCADDEN LCSW-CA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 CAPISTRANO AVE STE G
ATASCADERO CA
93422-7227
US

IV. Provider business mailing address

PO BOX 1151
CAMBRIA CA
93428-1151
US

V. Phone/Fax

Practice location:
  • Phone: 805-466-3150
  • Fax: 805-466-3856
Mailing address:
  • Phone: 805-466-3150
  • Fax: 805-466-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS18267
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS78267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: