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NPI Code Detail

MEDICARE: DR. CANDACE WARD-MCKINLAY PH.D.

MEDICARE: DR. CANDACE WARD-MCKINLAY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistPSY7379CA

General Provider Information

NPI Number : 1104991322
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CANDACE WARD-MCKINLAY PH.D.
Provider Business Mailing Address
First Line : 2966 NIGHT WATCH WAY
Second Line :
City : ALPINE
State : CA
Zip : 91901-4115
Country : US
Telephone Number : 203-848-9716
Fax Number :
Provider Business Practice Location Address
First Line : 2271 ALPINE BLVD STE A
Second Line :
City : ALPINE
State : CA
Zip : 91901-1101
Country : US
Telephone Number : 203-848-9716
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 12/27/2024

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