Healthcare Provider Details

I. General information

NPI: 1457278608
Provider Name (Legal Business Name): CAITLIN CASE-GONZALEZ CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E REDLANDS BLVD STE 101
REDLANDS CA
92373-4775
US

IV. Provider business mailing address

78900 AVENUE 47 STE 100
LA QUINTA CA
92253-2070
US

V. Phone/Fax

Practice location:
  • Phone: 760-600-5811
  • Fax:
Mailing address:
  • Phone: 760-600-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: