Provider Demographics
NPI:1710874821
Name:SNOW, CAITHLYN T (ASWC)
Entity type:Individual
Prefix:MISS
First Name:CAITHLYN
Middle Name:T
Last Name:SNOW
Suffix:
Gender:F
Credentials:ASWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 THIBODO RD APT 208
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7945
Mailing Address - Country:US
Mailing Address - Phone:760-917-8007
Mailing Address - Fax:
Practice Address - Street 1:1330 ORANGE AVE STE 308
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-3924
Practice Address - Country:US
Practice Address - Phone:619-837-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1258191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty