Individual
CANDY ALEXANDRA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 HUERTA AVE, GREENFIELD, CA 93927-5762
(831) 674-2180
Mailing address
18225 HALE AVE, MORGAN HILL, CA 95037-3547
(408) 465-8280
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
164X00000X
Licensed Vocational Nurse
Primary
718718
CA
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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