Provider Demographics
NPI:1871202051
Name:CANCHOLA, LAUREN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:CANCHOLA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:VALDESPINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29873 SANTA MARGARITA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3626
Mailing Address - Country:US
Mailing Address - Phone:949-709-0988
Mailing Address - Fax:
Practice Address - Street 1:29873 SANTA MARGARITA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3626
Practice Address - Country:US
Practice Address - Phone:949-709-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily