Provider Demographics
NPI:1841185410
Name:THEBERGE, CANDACE (BA, MED)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:THEBERGE
Suffix:
Gender:F
Credentials:BA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63624 CRICKETWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9791
Mailing Address - Country:US
Mailing Address - Phone:603-616-8816
Mailing Address - Fax:
Practice Address - Street 1:360 SW BOND ST STE 330
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3556
Practice Address - Country:US
Practice Address - Phone:541-706-6777
Practice Address - Fax:541-706-6777
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator