Individual provider Active NPI

Candice Valencia Wilkins, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1700439684
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW108132 Issued in CA
Practice address
2490 W Shaw Ave Ste 101
Fresno, CA 93711-3063
Phone
(559) 248-8579
Fax
(559) 320-0058
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW108132 CA Primary

Addresses

Primary practice location

2490 W Shaw Ave Ste 101
Fresno, CA 93711-3063

Mailing address

2490 W Shaw Ave Ste 101
Fresno, CA 93711-3063
Phone (559) 248-8579

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
I20230619001060 CA Practitioner - Clinical Social Worker 5698133981 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hinds Hospice CurrentSince Apr 16, 2023 Accepting new patients
Hinds Hospice CurrentSince Apr 16, 2023 Accepting new patients

Locations

2490 W Shaw Ave
Ste 101
Fresno, CA 93711
Phone (559) 226-5683

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1700439684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 W SHAW AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113063",
            "telephone_number": "559-248-8579",
            "fax_number": "559-320-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 W SHAW AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113063",
            "telephone_number": "559-248-8579",
            "fax_number": "559-320-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "CANDICE",
        "middle_name": "VALENCIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW108132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.