MEDICARE: CAITLIN ADDISON-HOWARD

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	104100000X	Social Worker	15099	CA

General Provider Information

NPI Number	:	1871717553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN ADDISON-HOWARD

Provider Business Mailing Address
First Line	:	1950A HARVEY WEST BLVD.
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2312
Country	:	US
Telephone Number	:	831-247-0570
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 HARVEY WEST BLVD
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2126
Country	:	US
Telephone Number	:	831-469-1700
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/20/2007

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Directions to “ CAITLIN ADDISON-HOWARD ” Practice Location

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