Provider Demographics
NPI:1023722758
Name:JAMES, CANDICE (IBCLC)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 ENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5608
Mailing Address - Country:US
Mailing Address - Phone:805-835-2777
Mailing Address - Fax:
Practice Address - Street 1:6606 ENFIELD AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5608
Practice Address - Country:US
Practice Address - Phone:805-835-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
300827174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN