Healthcare Provider Details

I. General information

NPI: 1558299842
Provider Name (Legal Business Name): VERONICA CANCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1573 MEADOW ST
COALINGA CA
93210-3257
US

IV. Provider business mailing address

1573 MEADOW ST
COALINGA CA
93210-3257
US

V. Phone/Fax

Practice location:
  • Phone: 559-410-7060
  • Fax:
Mailing address:
  • Phone: 559-410-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW119828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: