Provider Demographics
NPI:1851561153
Name:SETI, CANDICE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:SETI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 10TH AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-8705
Mailing Address - Country:US
Mailing Address - Phone:619-345-4355
Mailing Address - Fax:
Practice Address - Street 1:350 10TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-8705
Practice Address - Country:US
Practice Address - Phone:619-345-4355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048.0134754TELE103TC0700X
COPSY0005767103TC0700X
NY025561103TC0700X
FL287103TC0700X
CAPSY21609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical