Provider Demographics
NPI:1790830404
Name:WHEALON, CANDICE ELIZABETH (RN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:ELIZABETH
Last Name:WHEALON
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:MISS
Other - First Name:CANDICE
Other - Middle Name:ELIZABETH
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11620 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1776
Mailing Address - Country:US
Mailing Address - Phone:805-479-8503
Mailing Address - Fax:310-362-9240
Practice Address - Street 1:11620 WILSHIRE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1776
Practice Address - Country:US
Practice Address - Phone:805-479-8503
Practice Address - Fax:310-362-9240
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23718363L00000X, 363LF0000X
CA653544163W00000X
NJ26NJ00835400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes163W00000XNursing Service ProvidersRegistered Nurse