Individual provider Active NPI

Candyce Flemister, AMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1437639515
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
107679 Issued in CA
Practice address
9890 County Farm Rd Ste 2
Riverside, CA 92503-3678
Phone
(951) 509-2499
NPI assigned
Aug 17, 2018
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 107679 CA Primary

Addresses

Primary practice location

9890 County Farm Rd Ste 2
Riverside, CA 92503-3678

Mailing address

9825 Magnolia Ave Ste B
Riverside, CA 92503-3565

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001925 CA Practitioner - Marriage and Family Therapist 2062855596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910
Phone (442) 327-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131091CAMDSocial Worker
107679CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Coast to Coast Psychological Services Marriage & Family Therapist Past Accepting new patients

Locations

3610 Central Ave
Ste 500
Riverside, CA 92506
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

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, 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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1437639515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 MAGNOLIA AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9890 COUNTY FARM RD STE 2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033678",
            "telephone_number": "951-509-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMISTER",
        "first_name": "CANDYCE",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "107679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.