Provider Demographics
NPI:1376881789
Name:WINDSOR, CAITLIN ANNVELMA (BA)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ANNVELMA
Last Name:WINDSOR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E ALESSANDRO BLVD STE 3C
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-2464
Mailing Address - Country:US
Mailing Address - Phone:951-329-9590
Mailing Address - Fax:951-335-8622
Practice Address - Street 1:301 E ALESSANDRO BLVD STE 3C
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-2464
Practice Address - Country:US
Practice Address - Phone:951-329-9590
Practice Address - Fax:951-335-8622
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 7610237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist