Provider Demographics
NPI:1013660992
Name:CANFIELD, CASSAUNDRA
Entity Type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:
Last Name:CANFIELD
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 1:2784 BUTLER CT
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4445
Mailing Address - Country:US
Mailing Address - Phone:661-342-7361
Mailing Address - Fax:
Practice Address - Street 1:9075 ELK GROVE BLVD # 220A
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2070
Practice Address - Country:US
Practice Address - Phone:916-701-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist