Provider Demographics
NPI:1295448421
Name:EAKIN, CANDICE NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:NICOLE
Last Name:EAKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:NICOLE
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11985 HERITAGE OAK PL
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:530-400-4971
Mailing Address - Fax:530-889-4978
Practice Address - Street 1:11985 HERITAGE OAK PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2413
Practice Address - Country:US
Practice Address - Phone:530-400-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-119271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical