Provider Demographics
NPI:1891248787
Name:BAKKIE, CAYLAN (LMFT)
Entity Type:Individual
Prefix:
First Name:CAYLAN
Middle Name:
Last Name:BAKKIE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 VERBENA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2945
Mailing Address - Country:US
Mailing Address - Phone:530-208-0663
Mailing Address - Fax:
Practice Address - Street 1:2220 SAINT GEORGE LN STE 3
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1307
Practice Address - Country:US
Practice Address - Phone:530-208-0663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128578101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health