NPI Code Details Logo

NPI 1396616868

NPI 1396616868 : CANDICE CAMP : ALAMEDA, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1396616868
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CANDICE CAMP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/16/2025
-----------------------------------------------------
    Last Update Date     |    10/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    400 PACKET LANDING RD 
-----------------------------------------------------
    City                 |    ALAMEDA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94502-6534
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-748-4003
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1305 WEBSTER ST APT C305 
-----------------------------------------------------
    City                 |    ALAMEDA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94501-3863
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-703-9400
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    171400000X
-----------------------------------------------------
    Taxonomy Name        |    Health & Wellness Coach
-----------------------------------------------------
    License Number       |    7422362635
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.