Mireya Canchola, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95014984 Issued in CA

Practice address

1415 Ross Ave.
Sunflower CT.
El Centro, CA 92243-9224

Phone

(760) 339-7100

NPI assigned

Nov 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

State licenses

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1972104602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SUNFLOWER CT",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922438425",
            "telephone_number": "760-840-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE.",
            "address_2": "SUNFLOWER CT.",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439224",
            "telephone_number": "760-339-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCHOLA",
        "first_name": "MIREYA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95014984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Abiel Canales
• Cancer Resource Center of the Desert
• Cancer Resource Center of the Desert
• Cancer Resource Center of the Desert
• Fabian Canchola
• Audelia G Canez, LCSW
• Kathrane Marie Canizales
• Candice Marie Cano, CD
• Carla A Cano
• Michelle S Capps, RN.

• Family Nurse Practitioner in El Centro, CA
• Providers in El Centro, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.