Provider Demographics
NPI:1780129874
Name:RILLON, CANDEE DIONE
Entity type:Individual
Prefix:MISS
First Name:CANDEE
Middle Name:DIONE
Last Name:RILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15-2760 KUMU ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-9205
Mailing Address - Country:US
Mailing Address - Phone:808-895-0458
Mailing Address - Fax:
Practice Address - Street 1:15-2760 KUMU ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-9205
Practice Address - Country:US
Practice Address - Phone:808-895-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-27
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YS0200X
HI780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool