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General NPI Number Information
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NPI Number | 1427397181
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Entity Type | Individual
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Provider Name | KANDYCE ANN FILLMORE RDHAP
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Gender | Female
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 4915 COLLEGE AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93306-3953
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Country | US
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Telephone | 661-865-0092
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Fax |
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Provider Business Mailing Address
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Address Line | 11200 MEACHAM RD
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2041
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Country | US
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Telephone | 661-865-0092
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | HAP140
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License Number State | CA
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