Provider Demographics
NPI:1518091982
Name:RESENDEZ, CANDELARIO LARRY II
Entity Type:Individual
Prefix:DR
First Name:CANDELARIO
Middle Name:LARRY
Last Name:RESENDEZ
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25538 VIA PACIFICA
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2650
Mailing Address - Country:US
Mailing Address - Phone:661-286-2562
Mailing Address - Fax:661-222-7709
Practice Address - Street 1:23502 LYONS AVE STE 304
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2538
Practice Address - Country:US
Practice Address - Phone:661-286-2562
Practice Address - Fax:661-222-7709
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17289103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical