Provider Demographics
NPI:1699197798
Name:JARJOSA, CANDACE CATHERINE
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:CATHERINE
Last Name:JARJOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2781 SAGEBRUSH CIR
Mailing Address - Street 2:APT 205
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8778
Mailing Address - Country:US
Mailing Address - Phone:248-202-2639
Mailing Address - Fax:
Practice Address - Street 1:2781 SAGEBRUSH CIR
Practice Address - Street 2:APT 205
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8778
Practice Address - Country:US
Practice Address - Phone:248-202-2639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker