Provider Demographics
NPI:1912449174
Name:BELSHE, CANDICE JADE (MS)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:JADE
Last Name:BELSHE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:JADE
Other - Last Name:SKAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24271 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7201
Mailing Address - Country:US
Mailing Address - Phone:949-233-9793
Mailing Address - Fax:
Practice Address - Street 1:24271 BONNIE LN
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7201
Practice Address - Country:US
Practice Address - Phone:949-233-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE10732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist