Healthcare Provider Details

I. General information

NPI: 1235057746
Provider Name (Legal Business Name): CANDACE ELIZABETH ALTHEN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28999 OLD TOWN FRONT ST STE 101
TEMECULA CA
92590-2842
US

IV. Provider business mailing address

28999 OLD TOWN FRONT ST STE 101
TEMECULA CA
92590-2842
US

V. Phone/Fax

Practice location:
  • Phone: 951-261-8392
  • Fax:
Mailing address:
  • Phone: 951-261-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number721391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: