Provider Demographics
NPI:1073770061
Name:CANDELL, ARIANA (MA)
Entity Type:Individual
Prefix:MS
First Name:ARIANA
Middle Name:
Last Name:CANDELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:ARIANA
Other - Middle Name:
Other - Last Name:CANDELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2915 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2133
Mailing Address - Country:US
Mailing Address - Phone:510-466-5114
Mailing Address - Fax:510-531-5766
Practice Address - Street 1:2915 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2133
Practice Address - Country:US
Practice Address - Phone:510-466-5114
Practice Address - Fax:510-531-5766
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist