Healthcare Provider Details

I. General information

NPI: 1124935572
Provider Name (Legal Business Name): CAITLIN RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 SANTA FE DR
ENCINITAS CA
92024-5142
US

IV. Provider business mailing address

354 SANTA FE DR
ENCINITAS CA
92024-5142
US

V. Phone/Fax

Practice location:
  • Phone: 469-471-5817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number70012
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number10528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: