Individual
MRS. CANDACE LILLIAN DIREZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3555 LUTHERAN PKWY STE 200, WHEAT RIDGE, CO 80033-6027
(720) 284-3700
Mailing address
9841 UPHAM DR, WESTMINSTER, CO 80021-4070
(303) 422-4369
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
CO 1444
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45274819
—
CO
Enumeration date
05/12/2006
Last updated
06/12/2013
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