Healthcare Provider Details

I. General information

NPI: 1316152309
Provider Name (Legal Business Name): CHRISTINE ANNE CAUFFIELD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 OSCEOLA AVE APARTMENT 509
WINTER PARK FL
32789-4449
US

IV. Provider business mailing address

690 OSCEOLA AVE APARTMENT 509
WINTER PARK FL
32789-4449
US

V. Phone/Fax

Practice location:
  • Phone: 407-539-2239
  • Fax:
Mailing address:
  • Phone: 407-539-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY6095
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: