Healthcare Provider Details

I. General information

NPI: 1477029676
Provider Name (Legal Business Name): CAITLIN JOHNSON ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 BAILEY ST
HANFORD CA
93230-5922
US

IV. Provider business mailing address

1393 BAILEY ST
HANFORD CA
93230-5922
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-4481
  • Fax:
Mailing address:
  • Phone: 559-582-4481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB458244
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW137890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: