Healthcare Provider Details

I. General information

NPI: 1407724826
Provider Name (Legal Business Name): CANDACE LENAY FAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 BELVEDERE AVE
BAKERSFIELD CA
93304-5430
US

IV. Provider business mailing address

6010 HATHAWAY AVE
BAKERSFIELD CA
93313-6121
US

V. Phone/Fax

Practice location:
  • Phone: 661-396-8690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number134271
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: