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Individual

CAITLIN KWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
450 S MARENGO AVE, PASADENA, CA 91101-3113
(626) 714-2964
Mailing address
PO BOX 93468, PASADENA, CA 91109-3468

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
119468
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119468
REGISTERED ASSOCIATE MFT
CA
Enumeration date
10/06/2020
Last updated
10/06/2020
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