Provider Demographics
NPI:1093836801
Name:ERBA, CANDICE MARIE
Entity Type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:MARIE
Last Name:ERBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:MARIE
Other - Last Name:COE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3010 I ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4420
Mailing Address - Country:US
Mailing Address - Phone:916-441-2020
Mailing Address - Fax:
Practice Address - Street 1:3010 I ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4420
Practice Address - Country:US
Practice Address - Phone:916-441-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS110091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical