Healthcare Provider Details

I. General information

NPI: 1215861851
Provider Name (Legal Business Name): EMMANUELLE DIGNA CANDELARIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

8810 ETIWANDA AVE APT 1
NORTHRIDGE CA
91325-3086
US

IV. Provider business mailing address

8810 ETIWANDA AVE APT 1
NORTHRIDGE CA
91325-3086
US

V. Phone/Fax

Practice location:
  • Phone: 213-373-3770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: