Provider Demographics
NPI:1972358869
Name:PAPPAS, CAITLEN
Entity Type:Individual
Prefix:
First Name:CAITLEN
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLEN
Other - Middle Name:
Other - Last Name:SISSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1641 PAMELA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-3138
Mailing Address - Country:US
Mailing Address - Phone:707-591-4308
Mailing Address - Fax:
Practice Address - Street 1:1641 PAMELA DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-3138
Practice Address - Country:US
Practice Address - Phone:707-591-4308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical