Provider Demographics
NPI:1932251790
Name:ADAMS, CANDY (PT, MS)
Entity Type:Individual
Prefix:MRS
First Name:CANDY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:MISS
Other - First Name:CANDY
Other - Middle Name:
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MS
Mailing Address - Street 1:533 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-2302
Mailing Address - Country:US
Mailing Address - Phone:530-846-8018
Mailing Address - Fax:530-846-8019
Practice Address - Street 1:1516 STATE HIGHWAY 99
Practice Address - Street 2:SUITE G
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-3126
Practice Address - Country:US
Practice Address - Phone:530-846-8018
Practice Address - Fax:530-846-8019
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT244111Medicare ID - Type Unspecified