CANDICE CASTRO MEDINA (NPI# 1487017919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487017919 |
| Entity Type | Individual |
| Full Name | CANDICE CASTRO MEDINA |
| Credential | FNP-C |
| Practice Address |
26520 Cactus Ave Moreno Valley CA 92555-3927 |
| Mailing Address |
14604 Serenade Dr Corona CA 92880-1075 |
| Practice Telephone | 9514860000 |
| Practice Fax Number | 9514860000 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SE0003X |
Clinical Nurse Specialist Specialization: Emergency |
F0216643 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
26520 CACTUS AVE |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92555-3927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546414 | Menard Barruga | Pediatrics | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2005-08-24 |
| 1942816392 | Sheron Mathew | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-21 |
| 1669086237 | Brittany Noel Speer | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-01 |
| 1548873110 | Garrett Bao Kha Tran Long | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1639782063 | Yinxi Wu | Social Worker | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1124636246 | Marie Therese Fonseca | Counselor | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-15 |
| 1396363545 | Jackson Helms | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-13 |
| 1588282024 | Adam Kreutzer | Orthopaedic Surgery | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1861010316 | Nicholas Bast | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1699392449 | Xiao Song | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817935 | Jillian Mika Ogata | Social Worker | Riverside University Health System, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2020-10-05 |
| 1114549144 | Providence Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 11165 Bonnie View Ave, Moreno Valley, CA 92555 | 2020-05-13 |
| 1720645096 | Shahida Nawaz | Non-emergency Medical Transport (VAN) | 26528 Primrose Way, Moreno Valley, CA 92555 | 2019-05-22 |
| 1679139828 | Moses Lee | Student in an Organized Health Care Education/Training Program | Department of Orthopaedic Surgery Rm. B2042 Ruhs-mc, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2019-05-14 |
| 1215419668 | Johannes Wattimena | Counselor | 26624 Saffron Circle, Moreno Valley, CA 92555 | 2018-09-02 |
| 1437676939 | Aleksandra Vargas | Behavioral Analyst | 12549 Atherton Dr, Moreno Valley, CA 92555 | 2017-08-25 |
| 1063938603 | Anthony I Odimegwu | Nurse Practitioner | 26062 Bercaw Ct, Moreno Valley, CA 92555 | 2017-08-16 |
| 1073036703 | Karen Parker | Licensed Psychiatric Technician | 12944 Dolomite Lane, Moreno Valley, CA 92555 | 2017-07-25 |
| 1861923674 | Elena Vizcaino | Behavior Technician | 15670 Turnberry St, Moreno Valley, CA 92555 | 2017-03-23 |
| 1154744522 | Nancy Chivichon | Dietitian, Registered | 28648 Avenue Ave., Moreno Valley, CA 92555 | 2014-01-21 |
| Find all providers in zip 92555 | ||||
| Taxonomy Code | 364SE0003X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Emergency |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194262113 | Jennifer Glidden | Clinical Nurse Specialist | 10336 Wilshire Blvd, 602, Los Angeles, CA 90024-4730 | 2017-01-28 |
| 1134188501 | Joshua Salome Inez Luftig | Clinical Nurse Specialist | 1411 East 31 Street, Oakland, CA 94602-1018 | 2006-03-22 |
| 1508832965 | Hilda A Villarreal | Clinical Nurse Specialist | 1209 Woodrow Ave, Modesto, CA 95350-1288 | 2006-02-27 |
| 1205347309 | Julie A Rossie | Clinical Nurse Specialist | 700 Lawrence Expy, Santa Clara, CA 95051-5173 | 2017-10-16 |
| 1548353329 | Harold Edward Baker Ix | Clinical Nurse Specialist | 825 Delbon Avenue, Turlock, CA 95380-2016 | 2006-10-02 |
| 1215986732 | Brandon Lee Shulman | Clinical Nurse Specialist | 1411 East 31st Street, Oakland, CA 94602-1018 | 2006-05-10 |
| 1003887480 | Patricia Scott Meyer | Clinical Nurse Specialist | 1411 E 31st St, Oakland, CA 94602-1018 | 2006-02-01 |
| 1457331373 | Linda J Shipp | Clinical Nurse Specialist | 825 Delbon Ave, Turlock, CA 95380-2016 | 2006-01-18 |
| 1962482877 | Shane Andrew Tipton | Clinical Nurse Specialist | 1000 Greenley Rd, Sonora, CA 95370-5200 | 2006-01-18 |
| 1225018237 | Kuljinder Dosanjh | Clinical Nurse Specialist | 825 Delbon Ave, Turlock, CA 95382-2016 | 2006-01-18 |
| Find all providers with the same taxonomy | ||||
| City | MORENO VALLEY |
| Zip Code | 92555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.