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General NPI Number Information
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NPI Number | 1942721410
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Entity Type | Individual
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Provider Name | CANDACE LYNN MCCRACKEN RDHAP,RDH
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 5000 BECHELLI LN STE 102
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City | REDDING
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State | CA
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Zip | 96002-3553
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Country | US
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Telephone | 530-945-4029
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Fax | 530-319-3993
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Provider Business Mailing Address
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Address Line | 9596 HOLLYWOOD DR
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City | PALO CEDRO
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State | CA
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Zip | 96073-8704
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Country | US
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Telephone | 530-945-4029
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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 | HAP661
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License Number State | CA
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