Provider Demographics
NPI:1629415716
Name:GIRA, CANDACE
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:
Last Name:GIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CJ
Other - Middle Name:
Other - Last Name:GIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LADC
Mailing Address - Street 1:4441 AUBURN BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4139
Mailing Address - Country:US
Mailing Address - Phone:916-473-5764
Mailing Address - Fax:916-473-5766
Practice Address - Street 1:4441 AUBURN BLVD STE E
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4139
Practice Address - Country:US
Practice Address - Phone:916-473-5764
Practice Address - Fax:916-473-5766
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)