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General NPI Number Information
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NPI Number | 1023138187
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Entity Type | Individual
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Provider Name | MISS CANDY CACERES
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 2121 TEMPLE ST
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City | LOS ANGELES
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State | CA
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Zip | 90026-1831
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Country | US
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Telephone | 213-385-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 550 FANO ST APT 103
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City | MONROVIA
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State | CA
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Zip | 91016-5235
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Country | US
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Telephone | 323-363-9607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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