Individual
MS. CANDICE ROSIE PORRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A.
Contact information
Practice address
18612 SANTA ANA AVE, BLOOMINGTON, CA 92316-2639
(909) 421-7120
Mailing address
18612 SANTA ANA AVE, BLOOMINGTON, CA 92316-2639
(909) 421-7120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ICAN877
LA COUNTY DMH
CA
Enumeration date
01/19/2010
Last updated
04/05/2024
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