Individual
CANDACE MAE VAILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 E 6TH ST, LOS ANGELES, CA 90021-1009
(213) 529-0963
Mailing address
21163 CONKLIN BLVD, CALIFORNIA CITY, CA 93505-2273
(909) 242-1940
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
11/07/2022
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