Individual
CAITLYN DIEBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3841 BRICKWAY BLVD, SANTA ROSA, CA 95403-8226
(707) 569-2300
Mailing address
3841 BRICKWAY BLVD, SANTA ROSA, CA 95403-8226
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
65191
CA
Other
Enumeration date
09/14/2015
Last updated
03/09/2020
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