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General NPI Number Information
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NPI Number | 1164763702
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Entity Type | Individual
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Provider Name | CAITLIN MONICA CRUM
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Gender | Female
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Dates
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Enumeration Date | 03/06/2013
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 400 29TH ST STE. 102
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City | OAKLAND
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State | CA
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Zip | 94609-3522
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Country | US
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Telephone | 510-239-3064
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Fax |
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Provider Business Mailing Address
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Address Line | 920 SEAVIEW DR
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City | EL CERRITO
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State | CA
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Zip | 94530-3011
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Country | US
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Telephone | 415-271-2930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 84338
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License Number State | CA
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