Provider Demographics
NPI:1437995651
Name:WILLIAMS, CANDY ALISHA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CANDY
Middle Name:ALISHA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22662 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3038
Mailing Address - Country:US
Mailing Address - Phone:510-798-2723
Mailing Address - Fax:
Practice Address - Street 1:22662 7TH ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3038
Practice Address - Country:US
Practice Address - Phone:510-798-2723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66256225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist