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NPI Code Detail

MEDICARE: KAITLYN ODDO

MEDICARE: KAITLYN ODDO
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 Worker136562CA

General Provider Information

NPI Number : 1912725813
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN ODDO
Provider Business Mailing Address
First Line : 380 ENCINAL ST STE 200
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-2178
Country : US
Telephone Number : 831-469-1700
Fax Number : 831-425-1905
Provider Business Practice Location Address
First Line : 380 ENCINAL ST STE 200
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-2178
Country : US
Telephone Number : 831-469-1700
Fax Number : 831-425-1905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2024
Last Update Date : 01/21/2026

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Directions to “ KAITLYN ODDO ” Practice Location

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