Provider Demographics
NPI:1225222342
Name:SELOVER, CANDACE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:SELOVER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 ROUX CT
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-8600
Mailing Address - Country:US
Mailing Address - Phone:925-286-7054
Mailing Address - Fax:
Practice Address - Street 1:1155 ARNOLD DR STE C
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6536
Practice Address - Country:US
Practice Address - Phone:925-286-7054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27942103TC0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical