Provider Demographics
NPI:1851596852
Name:CAULFIELD, DAVID (MA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CAULFIELD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 W HOBSONWAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1508
Mailing Address - Country:US
Mailing Address - Phone:760-922-0941
Mailing Address - Fax:760-360-4591
Practice Address - Street 1:417 W HOBSONWAY
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1508
Practice Address - Country:US
Practice Address - Phone:760-922-0941
Practice Address - Fax:760-360-4591
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT14452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist