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NPI Code Detail

MEDICARE: CANDICE RAZO

MEDICARE: CANDICE RAZO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1356205090
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE RAZO
Provider Business Mailing Address
First Line : 3333 CONCOURS STE 4102
Second Line :
City : ONTARIO
State : CA
Zip : 91764-6564
Country : US
Telephone Number :
Fax Number : 909-259-2369
Provider Business Practice Location Address
First Line : 3333 CONCOURS STE 4102
Second Line :
City : ONTARIO
State : CA
Zip : 91764-6564
Country : US
Telephone Number : 909-240-1764
Fax Number : 909-259-2369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ CANDICE RAZO ” Practice Location

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