Provider Demographics
NPI:1104986579
Name:TOYODA, CANDICE J (LPCC)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:J
Last Name:TOYODA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRC
Mailing Address - Street 1:1420 WILLOW PASS RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5223
Mailing Address - Country:US
Mailing Address - Phone:925-521-5155
Mailing Address - Fax:925-646-5680
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:SUITE 140
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5223
Practice Address - Country:US
Practice Address - Phone:925-646-5441
Practice Address - Fax:925-646-5680
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPC333101YM0800X
CACRC50029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50029OtherCOMMISSION ON REHABILITATION COUNSELING
CALPC333Medicaid