Provider Demographics
NPI:1104361708
Name:READHEAD, CAITLAN (ND)
Entity Type:Individual
Prefix:DR
First Name:CAITLAN
Middle Name:
Last Name:READHEAD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 GEARY ST APT 607
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1675
Mailing Address - Country:US
Mailing Address - Phone:704-806-1825
Mailing Address - Fax:
Practice Address - Street 1:1545 BROADWAY STE 1A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-2539
Practice Address - Country:US
Practice Address - Phone:415-563-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND842175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath