Provider Demographics
NPI:1346369477
Name:MCCANDLESS, PAUL M (MFT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:MCCANDLESS
Suffix:
Gender:M
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:714-391-1003
Mailing Address - Fax:714-992-4673
Practice Address - Street 1:733 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3805
Practice Address - Country:US
Practice Address - Phone:714-391-1003
Practice Address - Fax:714-992-4673
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist