Candy Marie Jara

Individual provider Active NPI Licensed Vocational Nurse · Joshua Tree, CA

NPI 1134824196 · NPPES record last updated Apr 25, 2024

Key facts

NPI
1134824196
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
284182 (CA)
Practice address
60805 29 Palms Hwy
Joshua Tree, CA 92252-5901
Phone
(760) 974-5990
NPI assigned
Mar 31, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
284182CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Star Behavioral Health, Inc. Past
since Apr 6, 2023
Accepting new patients
Valley Star Behavioral Health, Inc. Past
since Apr 6, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 284182 CA Yes

Addresses

Primary practice location

60805 29 Palms Hwy
Joshua Tree, CA 92252-5901

Mailing address

2500 N Palm Canyon Dr Ste A4
Palm Springs, CA 92262-1866
Phone (760) 424-5602

Other practice location 1

2500 N Palm Canyon Dr Ste A4
Palm Springs, CA 92262-1866
Phone (760) 424-5602

Other providers in Joshua Tree, CA

All providers in Joshua Tree, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.