Provider Demographics
NPI:1316095060
Name:KREMER, CANDACE MCDONALD (DC)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:MCDONALD
Last Name:KREMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CANDACE
Other - Middle Name:MARIA
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1635 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3229
Mailing Address - Country:US
Mailing Address - Phone:530-895-0224
Mailing Address - Fax:530-894-6750
Practice Address - Street 1:1635 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3229
Practice Address - Country:US
Practice Address - Phone:530-895-0224
Practice Address - Fax:530-894-6750
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0293300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0293300Medicare ID - Type Unspecified