Berenize Canchola

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

CG61556461 Issued in WA

Practice address

1319 Saul Rd
Sunnyside, WA 98944-2300

Phone

(509) 576-4337

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1366211583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 SAUL RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SAUL RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442300",
            "telephone_number": "509-576-4337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Wallace Way",
            "address_purpose": "LOCATION",
            "city": "Grandview",
            "state": "WA",
            "postal_code": "989308805",
            "country_code": "US",
            "telephone_number": "509-225-3396 x4037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANCHOLA",
        "first_name": "BERENIZE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "CG61556461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teodor D Butiu, MD
• Esteban Angel Cabrera, M.ED
• Mitchell David Cahn, M.D.
• Ludmina Svetlana Calayan
• Natalie Campuzano
• Carmen Marsela Cardenas, L.M.P.
• Marisol Cardenas, RDH
• Kylene N. Cardon, PA-C
• Care Center (Sunnyside) Inc.
• Nancy Casas Blanco

• Case Manager/Care Coordinator in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Case Manager/Care Coordinator in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.