Provider Demographics
NPI:1316243967
Name:CHAPMAN, CAITLIN (LMHC, PCI)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LMHC, PCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 SOUTHCREST AVENUE
Mailing Address - Street 2:SUITE
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110
Mailing Address - Country:US
Mailing Address - Phone:530-902-3335
Mailing Address - Fax:
Practice Address - Street 1:5252 BALBOA AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6906
Practice Address - Country:US
Practice Address - Phone:530-902-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-30
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7548101YM0800X
CAPCI 69101YM0800X
CA461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health