Healthcare Provider Details

I. General information

NPI: 1912822768
Provider Name (Legal Business Name): PRANALI ROMIL GAONKAR CHAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRANALI PRABHAKAR GAONKAR

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16700 NORWALK BLVD
CERRITOS CA
90703-1838
US

IV. Provider business mailing address

17912 ANTONIO AVE
CERRITOS CA
90703-8927
US

V. Phone/Fax

Practice location:
  • Phone: 562-926-5566
  • Fax:
Mailing address:
  • Phone: 562-374-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: