MEDICARE: CANDICE CRANDALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker		CA

General Provider Information

NPI Number	:	1447194048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE CRANDALL

Provider Business Mailing Address
First Line	:	2149 FARNWORTH ST
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-3309
Country	:	US
Telephone Number	:	805-377-7231
Fax Number	:

Provider Business Practice Location Address
First Line	:	2149 FARNWORTH ST
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-3309
Country	:	US
Telephone Number	:	805-377-7231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ CANDICE CRANDALL ” Practice Location

Language	Start Address	Practice Location

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