Healthcare Provider Details

I. General information

NPI: 1821247644
Provider Name (Legal Business Name): VERONICA CAUDILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 06/12/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

IV. Provider business mailing address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

V. Phone/Fax

Practice location:
  • Phone: 559-730-7566
  • Fax:
Mailing address:
  • Phone: 559-730-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT103984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: