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NPI Code Detail

MEDICARE: SASKYA PAOLA CAICEDO LCSW

MEDICARE: SASKYA PAOLA CAICEDO 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
11041C0700XClinical Social Worker118189CA

General Provider Information

NPI Number : 1669071767
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASKYA PAOLA CAICEDO LCSW
Provider Business Mailing Address
First Line : 8910 CLAIREMONT MESA BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6070 MISSION GORGE RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-4023
Country : US
Telephone Number : 619-333-4250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2020
Last Update Date : 09/27/2023

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