Provider Demographics
NPI:1932755352
Name:MYER, CANDACE IRENE (RN)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:IRENE
Last Name:MYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 VISTA CAMPANA N UNIT 42
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-8111
Mailing Address - Country:US
Mailing Address - Phone:747-301-1411
Mailing Address - Fax:
Practice Address - Street 1:MCAGCC MCCS STEPPING STONES
Practice Address - Street 2:DEL ZALLE DR BUILDING 693
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277
Practice Address - Country:US
Practice Address - Phone:760-830-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761884163WC1500X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health