Provider Demographics
NPI:1871989707
Name:BROBST, CAITLYNNE
Entity type:Individual
Prefix:
First Name:CAITLYNNE
Middle Name:
Last Name:BROBST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLYNNE
Other - Middle Name:
Other - Last Name:KARTCHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1450 N LAKE AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2301
Mailing Address - Country:US
Mailing Address - Phone:626-794-6071
Mailing Address - Fax:
Practice Address - Street 1:1459 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6092
Practice Address - Country:US
Practice Address - Phone:801-298-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10071691-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical