1154491835 NPI number — CATHERINE HELEN CASCADDEN LCSW-CA

Table of content: CATHERINE HELEN CASCADDEN LCSW-CA (NPI 1154491835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154491835 NPI number — CATHERINE HELEN CASCADDEN LCSW-CA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASCADDEN
Provider First Name:
CATHERINE
Provider Middle Name:
HELEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-CA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154491835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1151
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93428-1151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-466-3150
Provider Business Mailing Address Fax Number:
805-466-3856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5955 CAPISTRANO AVE
Provider Second Line Business Practice Location Address:
STE G
Provider Business Practice Location Address City Name:
ATASCADERO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93422-7227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-466-3150
Provider Business Practice Location Address Fax Number:
805-466-3856
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS78267 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: LCS18267 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SW18267 . This is a "PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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