Provider Demographics
NPI:1265147144
Name:CANO, CANDICE MARIE (CD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:MARIE
Last Name:CANO
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4347
Mailing Address - Country:US
Mailing Address - Phone:760-460-6085
Mailing Address - Fax:
Practice Address - Street 1:934 DRIFTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4347
Practice Address - Country:US
Practice Address - Phone:760-460-6085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula