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NPI Code Detail

MEDICARE: CANDICE TOMLIN

MEDICARE: CANDICE TOMLIN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134082886
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE TOMLIN
Provider Business Mailing Address
First Line : 9744 CERVELLI WAY
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-8368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9744 CERVELLI WAY
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-8368
Country : US
Telephone Number : 916-548-7692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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