NPIMap

Individual provider Active NPI

Candice Lanell Bain, MT-BC, PSYD

  • Clinical Neuropsychologist
  • Berkeley, CA
National Provider Identifier
1962875674
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35340 Issued in CA
Practice address
1918 University Ave Ste 2B
Berkeley, CA 94704-3264
Phone
(510) 548-9716
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Music Therapist 225A00000X 12038 CA
Clinical Psychologist 103TC0700X 35340 CA
Clinical Neuropsychologist 103G00000X 35340 CA Primary

Addresses

Primary practice location

1918 University Ave Ste 2B
Berkeley, CA 94704-3264

Mailing address

1918 University Ave Ste 2B
Berkeley, CA 94704-3264

Other practice location 1

1600 California Dr
Vacaville, CA 95687
Phone (707) 448-6841 ext. 2973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909001496 CA Practitioner - Clinical Psychologist 0446752331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City and County of San Francisco 368 clinicians

Practice addresses (Care Compare)

375 Laguna Honda Blvd
San Francisco, CA 94116-1411
Phone (415) 759-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12038CAMDPediatric Occupational Therapist
35340CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Aug 1, 2025 Accepting new patients
City & County of San Francisco Current Accepting new patients
City & County of San Francisco CurrentSince Aug 1, 2025 Accepting new patients

Locations

375 Laguna Honda Blvd
#B200
San Francisco, CA 94116
Phone (415) 759-3348

760 Harrison St
San Francisco, CA 94107
Phone (415) 836-1700

375 Laguna Honda Blvd
San Francisco, CA 94116
Phone (415) 759-2300

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1962875674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 UNIVERSITY AVE STE 2B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 UNIVERSITY AVE STE 2B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043264",
            "telephone_number": "510-548-9716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 California Dr",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "95687",
            "country_code": "US",
            "telephone_number": "707-448-6841 x2973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIN",
        "first_name": "CANDICE",
        "middle_name": "LANELL",
        "credential": "MT-BC, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "CA",
            "license": "12038",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35340",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "35340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.