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General NPI Number Information
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NPI Number | 1760017651
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Entity Type | Individual
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Provider Name | KANDICE RIVERS DNP, APRN-BC, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 2365 IRON POINT RD STE 210
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City | FOLSOM
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State | CA
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Zip | 95630-8713
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Country | US
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Telephone | 925-360-5264
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Fax |
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Provider Business Mailing Address
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Address Line | 8504 CHLOE LN
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-8100
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Country | US
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Telephone | 843-452-1470
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.23549
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23549
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95014958
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License Number State | CA
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