Healthcare Provider Details

I. General information

NPI: 1912830217
Provider Name (Legal Business Name): NATALIE CANDELA PPS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W CITRON ST
CORONA CA
92882-4051
US

IV. Provider business mailing address

1010 W CITRON ST
CORONA CA
92882-4051
US

V. Phone/Fax

Practice location:
  • Phone: 951-736-3221
  • Fax:
Mailing address:
  • Phone: 951-736-3221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: