Healthcare Provider Details

I. General information

NPI: 1356279228
Provider Name (Legal Business Name): ALONDRA CANCHOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 W CHAPMAN AVE STE 122
ORANGE CA
92868-2648
US

IV. Provider business mailing address

11930 BANNER DR APT 11
GARDEN GROVE CA
92843-1726
US

V. Phone/Fax

Practice location:
  • Phone: 949-989-6932
  • Fax: 949-989-7608
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: