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NPI Code Detail

MEDICARE: MISS CANDACE SHANTE WALLS

MEDICARE:  MISS CANDACE SHANTE WALLS
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
1106H00000XMarriage & Family Therapist138953CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437520715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CANDACE SHANTE WALLS
Provider Business Mailing Address
First Line : 3780 ROSIN CT STE 110
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1698
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3780 ROSIN CT STE 110
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1698
Country : US
Telephone Number : 916-441-0226
Fax Number : 916-441-0286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2015
Last Update Date : 03/04/2026

Similar Medicare Providers

1316102890 — MS. KAREN MARY CHOATE MSW
Practice Location Address:
3780 ROSIN CT STE 110
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Practice Fax:
1528458882 — MRS. MEGAN BENTEROU
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1336517267 — CINDY MARIA XIONG LCSW
Practice Location Address:
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Practice Fax:
1578936639 — SANDRA MOLINA AGUILAR
Practice Location Address:
3780 ROSIN CT STE 110
SACRAMENTO, CA
95834-1698
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Practice Fax:
1477000875 — DARA MARIE PASTOR LCSW
Practice Location Address:
3780 ROSIN CT STE 110
SACRAMENTO, CA
95834-1698
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Practice Fax: 916-441-6377
1427582733 — LANCE PEACOR
Practice Location Address:
3780 ROSIN CT STE 110
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95834-1698
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Directions to “ MISS CANDACE SHANTE WALLS ” Practice Location

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