Healthcare Provider Details

I. General information

NPI: 1881724375
Provider Name (Legal Business Name): CANDICE ANN URQUHART CAADAC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CANDICE ANN ZACHERY

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E BELLE TER
BAKERSFIELD CA
93307-3880
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-635-2980
  • Fax: 661-635-2983
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberA3728397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: