Provider Demographics
NPI:1760784599
Name:SCHMUTZLER, CANDICE AMBER (PT)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:AMBER
Last Name:SCHMUTZLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2006
Mailing Address - Country:US
Mailing Address - Phone:818-340-8858
Mailing Address - Fax:
Practice Address - Street 1:6325 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2006
Practice Address - Country:US
Practice Address - Phone:818-340-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37318OtherPT LICENSE