Healthcare Provider Details

I. General information

NPI: 1851443006
Provider Name (Legal Business Name): CANDACE WILLIAMS OSBORN MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 HAMILTON AVE SUITE #419
PALO ALTO CA
94301-2533
US

IV. Provider business mailing address

1450 GREENWOOD AVE
PALO ALTO CA
94301-3416
US

V. Phone/Fax

Practice location:
  • Phone: 650-322-1245
  • Fax: 650-322-1262
Mailing address:
  • Phone: 650-323-9629
  • Fax: 650-323-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 44605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: