Provider Demographics
NPI:1700439684
Name:WILKINS, CANDICE VALENCIA (MSW ASW)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:VALENCIA
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MSW ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 W SHAW AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3063
Mailing Address - Country:US
Mailing Address - Phone:559-248-8579
Mailing Address - Fax:559-320-0058
Practice Address - Street 1:2490 W SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3063
Practice Address - Country:US
Practice Address - Phone:559-248-8579
Practice Address - Fax:559-320-0058
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA897941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical