Provider Demographics
NPI:1750274312
Name:CHEATWOOD, CANDICE LEANN (MS, PPS)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:LEANN
Last Name:CHEATWOOD
Suffix:
Gender:F
Credentials:MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 PACHECO RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-5104
Mailing Address - Country:US
Mailing Address - Phone:661-837-6110
Mailing Address - Fax:
Practice Address - Street 1:1109 PACHECO RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5104
Practice Address - Country:US
Practice Address - Phone:661-837-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool