Individual provider Active NPI

Joseph Canchola, RN

  • General Practice Registered Nurse
  • Long Beach, CA
National Provider Identifier
1275288797
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN95268219 Issued in CA
Practice address
1775 Chestnut Ave
Long Beach, CA 90813-1674
Phone
(562) 599-8444
NPI assigned
Feb 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN95268219 CA Primary

Addresses

Primary practice location

1775 Chestnut Ave
Long Beach, CA 90813-1674

Mailing address

5509 Repetto Ave
Los Angeles, CA 90022-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN95268219CAMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services Inc. PastSince Feb 24, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1275288797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 REPETTO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 CHESTNUT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131674",
            "telephone_number": "562-599-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCHOLA",
        "first_name": "JOSEPH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "RN95268219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.