Provider Demographics
NPI:1548643992
Name:LA BRIE, CAITLIN ELISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:ELISE
Last Name:LA BRIE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N MADISON AVE
Mailing Address - Street 2:STE 707
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2046
Mailing Address - Country:US
Mailing Address - Phone:626-765-7556
Mailing Address - Fax:
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:STE 707
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2046
Practice Address - Country:US
Practice Address - Phone:626-765-7556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32211103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical