Candace P. Vickers, PH.D., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3332 Issued in CA

Practice address

8432 Magnolia Ave
California Baptist University
Riverside, CA 92504-3206

Phone

(951) 552-8129

NPI assigned

Dec 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• California Baptist University

  • Community Health Clinic/Center
  • Riverside, CA
  • NPI 1053134221
  NPD (past)
• California Baptist University

  • Student Health Clinic/Center
  • Riverside, CA
  • NPI 1184909947
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1396280616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8432 MAGNOLIA AVE",
            "address_2": "CALIFORNIA BAPTIST UNIVERSITY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043206",
            "telephone_number": "951-552-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8432 MAGNOLIA AVE",
            "address_2": "CALIFORNIA BAPTIST UNIVERSITY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043206",
            "telephone_number": "951-552-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "CANDACE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PH.D., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "3332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.