MEDICARE: MRS. CAITLIN ELAINE BERNARD-VINCENT

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1487810362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAITLIN ELAINE BERNARD-VINCENT

Provider Business Mailing Address
First Line	:	35563 OAK SPRINGS RD
Second Line	:
City	:	TOLLHOUSE
State	:	CA
Zip	:	93667-9610
Country	:	US
Telephone Number	:	559-408-4523
Fax Number	:

Provider Business Practice Location Address
First Line	:	35563 OAK SPRINGS RD
Second Line	:
City	:	TOLLHOUSE
State	:	CA
Zip	:	93667-9610
Country	:	US
Telephone Number	:	559-408-4523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	05/26/2023

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