Provider Demographics
NPI:1720269418
Name:REYES, CANDICE MARIE CASIM (MD)
Entity Type:Individual
Prefix:
First Name:CANDICE MARIE
Middle Name:CASIM
Last Name:REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CANDICE MARIE
Other - Middle Name:CASIM
Other - Last Name:YUVIENCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2335 E KASHIAN LN STE 280
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2211
Practice Address - Country:US
Practice Address - Phone:559-256-9690
Practice Address - Fax:559-256-9691
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122233207R00000X, 207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine