Healthcare Provider Details
I. General information
NPI: 1104986579
Provider Name (Legal Business Name): CANDICE J. TOYODA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/08/2006
Last Update Date: 04/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1420 WILLOW PASS RD SUITE 140
CONCORD CA
94520-5223
US
IV. Provider business mailing address
1420 WILLOW PASS RD SUITE 140
CONCORD CA
94520-5223
US
V. Phone/Fax
- Phone: 925-646-5441
- Fax: 925-646-5680
- Phone: 925-521-5155
- Fax: 925-646-5680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LPC333 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | CRC50029 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: