Provider Demographics
NPI:1255482790
Name:AKMAN, CANDACE MARIE (MS)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:MARIE
Last Name:AKMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:MARIE
Other - Last Name:AKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:900 COOMBS ST STE 257
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2906
Mailing Address - Country:US
Mailing Address - Phone:707-253-4046
Mailing Address - Fax:
Practice Address - Street 1:900 COOMBS ST STE 257
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2906
Practice Address - Country:US
Practice Address - Phone:707-253-4046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicaid