{
"Npi": {
"NPI": "1790830404",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WHEALON",
"FirstName": "CANDICE",
"MiddleName": "ELIZABETH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "R.N., FNP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ZIMMERMAN",
"OtherFirstName": "CANDICE",
"OtherMiddleName": "ELIZABETH",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "R.N.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "11620 WILSHIRE BLVD STE 600",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90025-1776",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-479-8503",
"MailingAddressFaxNumber": "310-362-9240",
"FirstLinePracticeLocationAddress": "11620 WILSHIRE BLVD STE 600",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90025-1776",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-479-8503",
"PracticeLocationAddressFaxNumber": "310-362-9240",
"EnumerationDate": "01/24/2007",
"LastUpdateDate": "10/27/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "23718",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "23718",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "653544",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}