Amberly Cancino

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA59597 Issued in CA

Practice address

2333 S Mooney Blvd
Visalia, CA 93277-6228

Phone

(559) 205-1800

Fax

(559) 205-1770

NPI assigned

Mar 23, 2019

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pixley, CA
  • NPI 1033661558
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1326317819
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Goshen, CA
  • NPI 1336237072
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Dinuba, CA
  • NPI 1386140044
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Springville, CA
  • NPI 1386738177
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Terra Bella, CA
  • NPI 1831520048
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1073997201
  NPD (past)

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1972063030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932776228",
            "telephone_number": "559-205-1800",
            "fax_number": "559-205-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932776228",
            "telephone_number": "559-205-1800",
            "fax_number": "559-205-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCINO",
        "first_name": "AMBERLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-23",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59597",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Isaac Campos, NP
• Stacey Campos
• Edgar Canada
• Richard Terrell Canada, DDS MS
• Yesenia Canales
• Carmen Cano
• Michelle Cooper Cantrell, O.D.
• Steven Michael Cantrell, M.D.
• Emerolina Cantu
• Marlene Maria Cantu, LMFT

• Physician Assistant in Visalia, CA
• Providers in Visalia, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.