Healthcare Provider Details

I. General information

NPI: 1639081649
Provider Name (Legal Business Name): KATYA CANELO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43141 BUSINESS CENTER PKWY STE 101-102
LANCASTER CA
93535-4532
US

IV. Provider business mailing address

43141 BUSINESS CENTER PKWY STE 101-102
LANCASTER CA
93535-4532
US

V. Phone/Fax

Practice location:
  • Phone: 844-788-3965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number240246487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: