Provider Demographics
NPI:1407239486
Name:PAYNE, CANDICE LEE (HHP, BA)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:LEE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:HHP, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 RIO VISTA LN
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2081
Mailing Address - Country:US
Mailing Address - Phone:530-690-2978
Mailing Address - Fax:
Practice Address - Street 1:741 MAIN ST
Practice Address - Street 2:SUITE 112
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3359
Practice Address - Country:US
Practice Address - Phone:530-690-2978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath