Provider Demographics
NPI:1215134937
Name:FERRITER, CAITLIN (PHD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:FERRITER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8685 RIO SAN DIEGO DR
Mailing Address - Street 2:APT 4209
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-6551
Mailing Address - Country:US
Mailing Address - Phone:617-290-9904
Mailing Address - Fax:
Practice Address - Street 1:VA SAN DIEGO
Practice Address - Street 2:3350 LA JOLLA VILLAGE DR.
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:617-290-9904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 25124103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical