Provider Demographics
NPI:1194844910
Name:MCCANDLESS, SANDRA LEE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LEE
Last Name:MCCANDLESS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 BARRIS DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1001
Mailing Address - Country:US
Mailing Address - Phone:714-321-4619
Mailing Address - Fax:
Practice Address - Street 1:134 S GLASSELL ST
Practice Address - Street 2:SUITE I
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1434
Practice Address - Country:US
Practice Address - Phone:714-321-4619
Practice Address - Fax:562-434-5181
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist