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NPI Code Detail

MEDICARE: MS. CAROL CANDIOTTI NP

MEDICARE:  MS. CAROL  CANDIOTTI  NP
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
1363L00000XNurse PractitionerNP7040/CA

General Provider Information

NPI Number : 1346264967
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL CANDIOTTI NP
Provider Business Mailing Address
First Line : 5601 DEER VALLEY RD
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-8577
Country : US
Telephone Number : 925-813-3400
Fax Number :
Provider Business Practice Location Address
First Line : 5601 DEER VALLEY RD
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-8577
Country : US
Telephone Number : 925-813-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 12/30/2021

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