Provider Demographics
NPI:1104372044
Name:WOODHOUSE, CAITLYN (LPCC)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:WOODHOUSE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2765
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95024-2765
Mailing Address - Country:US
Mailing Address - Phone:408-202-3918
Mailing Address - Fax:
Practice Address - Street 1:2660 SOLACE PL STE D2
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4337
Practice Address - Country:US
Practice Address - Phone:408-202-3918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4241101YM0800X, 101YP2500X
CA9441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health