Candice Brantley, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Squaw Valley, CA
NPI 1275926164 · NPPES record last updated Mar 17, 2015
Key facts
- NPI
- 1275926164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95001891 (CA)
- Practice address
- 30924 E Kings Canyon Rd
Squaw Valley, CA 93675-9601 - Phone
- (559) 332-9399
- Fax
- (559) 332-9499
- NPI assigned
- Mar 17, 2015
- Sex
- Female
- Sole proprietor
- No
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Alabama School of Medicine, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
305 E Ctr Ave
Visalia, CA 93291-6331
Hospital & facility affiliations
- Adventist Health Reedley
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160317002277 | CA | Order and Referring Only - Nurse Practitioner | 5092012005 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95001891 | CA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95001891 | CA | Yes |
Addresses
Primary practice location
30924 E Kings Canyon Rd
Squaw Valley, CA 93675-9601
Mailing address
30924 E Kings Canyon
Squaw Valley, CA 93675
Other providers in Squaw Valley, CA
- Leticia C. Council
- Angela Fisher-Weaver
- Rebecca Emerita Geddes
- Joseph F Ruda Jr MD (a Medical Corporation )
- Gail Melton
All providers in Squaw Valley, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.