Provider Demographics
NPI:1265207138
Name:ENGLISH, CANDACE JEAN (MFT)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:JEAN
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:NATVIG
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:342 OAK LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-6202
Mailing Address - Country:US
Mailing Address - Phone:707-484-2553
Mailing Address - Fax:
Practice Address - Street 1:342 OAK LEAF CIR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409-6202
Practice Address - Country:US
Practice Address - Phone:707-484-2553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist