Healthcare Provider Details
I. General information
NPI: 1063589513
Provider Name (Legal Business Name): CAROLINE ATTERTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/29/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 W.MISSION AVE SUITE 103 NORTH INLAND MENTAL HEALTH CENTER
ESCONDIDO CA
92025
US
IV. Provider business mailing address
125 W.MISSION AVE. SUITE 103 NORTH INLAND MENTAL HEALTH CENTER
ESCONDIDO CA
92025
US
V. Phone/Fax
- Phone: 760-747-3424
- Fax: 760-747-3435
- Phone: 760-747-3424
- Fax: 760-747-3435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCS27249 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: