Provider Demographics
NPI:1518787399
Name:RUIZ CANCHOLA, DANIELA
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:RUIZ CANCHOLA
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 1:545 GARDEN HWY STE B
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-6338
Mailing Address - Country:US
Mailing Address - Phone:530-674-1885
Mailing Address - Fax:
Practice Address - Street 1:545 GARDEN HWY STE B
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6338
Practice Address - Country:US
Practice Address - Phone:530-674-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker