Individual
CANDACE FANALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4907 MORENA BLVD STE 1412, SAN DIEGO, CA 92117-7391
(858) 247-2417
Mailing address
3960 W POINT LOMA BLVD, STE #56720, SAN DIEGO, CA 92110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
30957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689907370
N/A
—
Enumeration date
09/12/2009
Last updated
06/07/2019
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