Provider Demographics
NPI:1124871702
Name:CANCHOLA, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name: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 1:700 AIRPORT BLVD STE 490
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1945
Mailing Address - Country:US
Mailing Address - Phone:650-339-8644
Mailing Address - Fax:
Practice Address - Street 1:700 AIRPORT BLVD STE 490
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1945
Practice Address - Country:US
Practice Address - Phone:650-339-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker