Healthcare Provider Details

I. General information

NPI: 1598431546
Provider Name (Legal Business Name): CANDACE HAMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 WILSHIRE BLVD
BEVERLY HILLS CA
90211-1848
US

IV. Provider business mailing address

7610 BEVERLY BLVD PO BOX 48473
LOS ANGELES CA
90048-5805
US

V. Phone/Fax

Practice location:
  • Phone: 310-205-5718
  • Fax:
Mailing address:
  • Phone: 562-400-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number141661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: