Healthcare Provider Details

I. General information

NPI: 1811883218
Provider Name (Legal Business Name): MRS. KAITLYN CHRISTINE-POWERS CUADERNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 S SAN ANTONIO RD STE 2
LOS ALTOS CA
94022-3055
US

IV. Provider business mailing address

840 SILACCI DR
CAMPBELL CA
95008-5125
US

V. Phone/Fax

Practice location:
  • Phone: 650-946-1200
  • Fax:
Mailing address:
  • Phone: 831-682-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPENDING
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: