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NPI Code Detail

MEDICARE: CAITLIN ALEXIS CARSON

MEDICARE: CAITLIN ALEXIS CARSON
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1982568721
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN ALEXIS CARSON
Provider Business Mailing Address
First Line : 4281 KATELLA AVE STE 117
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-3590
Country : US
Telephone Number : 562-596-0050
Fax Number : 562-596-0058
Provider Business Practice Location Address
First Line : 4281 KATELLA AVE STE 211
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-6500
Country : US
Telephone Number : 562-596-0050
Fax Number : 562-596-0058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ CAITLIN ALEXIS CARSON ” Practice Location

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