Candace A Heron, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F4621 Issued in CA

Practice address

6386 Greeley Hill Rd
Coulterville, CA 95311-9572

Phone

(209) 878-0155

NPI assigned

Feb 26, 2007

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

Other names 1

• Candace A Heron Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1821124751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6386 GREELEY HILL RD",
            "city": "COULTERVILLE",
            "state": "CA",
            "postal_code": "953119572",
            "telephone_number": "209-878-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6386 GREELEY HILL RD",
            "city": "COULTERVILLE",
            "state": "CA",
            "postal_code": "953119572",
            "telephone_number": "209-878-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERON",
        "first_name": "CANDACE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "F4621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "HERON",
            "middle_name": "A",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Coulterville, CA
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.