Individual ProviderKandace KiddBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address7949 California Ave Ste 15, Fair Oaks, CA 95628-7156(916) 863-7949PECOS EnrollmentBased on the most recent information from CMS, provider Kandace Kidd does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1669120036Provider TypeIndividualFull NameKidd, KandaceGenderFemaleSole ProprietorYesEnumeration Date3/15/2022Last Updated3/15/2022Contact InformationPractice LocationPractice Address7949 California Ave Ste 15, Fair Oaks, CA 95628-7156Phone(916) 863-7949FaxUnlisted FaxMailing LocationMailing Address7949 California Ave Ste 15, Fair Oaks, CA 95628-7156Phone(916) 863-7949FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer