Provider Demographics
NPI:1225319890
Name:BERNER, CAITLIN ERIN
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ERIN
Last Name:BERNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CADILLAC DR APT 119
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5416
Mailing Address - Country:US
Mailing Address - Phone:209-662-3961
Mailing Address - Fax:
Practice Address - Street 1:100 CADILLAC DR APT 119
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5416
Practice Address - Country:US
Practice Address - Phone:209-662-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program