Individual provider Active NPI

Vanessa J.F. Candare, PA

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1134680564
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56927 Issued in CA
Practice address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone
(714) 509-4077
Fax
(949) 898-6012
NPI assigned
Mar 28, 2019
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X 56927 CA
Physician Assistant 363A00000X PA56927 CA Primary

Addresses

Primary practice location

1201 W la Veta Ave
Orange, CA 92868-4203

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4077

Other practice location 1

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 966-6795

Other names 1

  • Vanessa Felicano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200611001122 CA Practitioner - Physician Assistant 3274954656 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA56927CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Rady Children's Hospital San Diego CurrentSince Apr 3, 2023 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Apr 3, 2023 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Mar 12, 2023 Accepting new patients
La Laser Center PC, a Professional Medical Corporation PastSince Feb 1, 2020 Accepting new patients
Regents of the University of California Past Accepting new patients
Clara Lucy Polak, M.D. Inc. PastSince Apr 1, 2020 Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3030 Childrens Way
San Diego, CA 92123
Phone (858) 966-4003

Interoperability endpoints

  • Direct secure messaging: vcandare318212@scrippshlth.medalliesdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1134680564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4077",
            "fax_number": "949-898-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4077",
            "fax_number": "949-898-6012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-6795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDARE",
        "first_name": "VANESSA",
        "middle_name": "J.F.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "56927",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "FELICANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.