Mariela Candido-Hernandez
Individual provider Active NPI Professional Counselor · Modesto, CA
NPI 1902308935 · NPPES record last updated Jan 30, 2026
Key facts
- NPI
- 1902308935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 153637 (CA)
- Practice address
- 1600 N Carpenter Rd Ste B
Modesto, CA 95351-1185 - Phone
- (209) 523-4573
- NPI assigned
- Mar 6, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 153637 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Treatment Centers, LLC | Past |
Accepting new patients | |
| Aegis Treatment Centers, LLC | Past |
Accepting new patients | |
| Aegis Treatment Centers, LLC | Past | Accepting new patients | |
| Aegis Treatment Centers, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 153637 | CA | Yes |
Addresses
Primary practice location
1600 N Carpenter Rd Ste B
Modesto, CA 95351-1185
Mailing address
1600 N Carpenter Rd Ste B
Modesto, CA 95351-1185
Phone (209) 523-4573
Other providers in Modesto, CA
- Ramona Lynn Canady
- Tania Vanessa Canales
- Pauline Mangoba Canas
- Tania Cancino
- Alma Candelario
- Joseph Canepa
- Samantha Catherine Canha
- Jeff Senor Cania
- Monique Antoinette Cannady
- Paula Lynn Cannistraci
All providers in Modesto, CA · Professional Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.