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General NPI Number Information
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NPI Number | 1740619063
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Entity Type | Individual
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Provider Name | CANDICE MICHELE DANIELS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 4425 S CENTRAL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90011-3629
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Country | US
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Telephone | 323-908-4200
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Fax | 323-985-9940
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Provider Business Mailing Address
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Address Line | 4425 S CENTRAL AVE
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City | LOS ANGELES
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State | CA
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Zip | 90011-3629
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Country | US
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Telephone | 323-908-4200
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Fax | 323-985-9940
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95015731
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 600765
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 345063
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License Number State | NY
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