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NPI Code Detail

MEDICARE: CAITLIN LOUISE FLEWELLING LCSW

MEDICARE:   CAITLIN LOUISE FLEWELLING  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
21041C0700XClinical Social Worker98954CA

General Provider Information

NPI Number : 1336528215
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN LOUISE FLEWELLING LCSW
Provider Business Mailing Address
First Line : 1601 PRECISION PARK LN
Second Line :
City : SAN DIEGO
State : CA
Zip : 92173-1345
Country : US
Telephone Number : 619-662-4100
Fax Number :
Provider Business Practice Location Address
First Line : 4004 BEYER BLVD
Second Line :
City : SAN YSIDRO
State : CA
Zip : 92173-2099
Country : US
Telephone Number : 619-662-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2015
Last Update Date : 04/18/2025

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Directions to “ CAITLIN LOUISE FLEWELLING LCSW” Practice Location

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