Healthcare Provider Details

I. General information

NPI: 1497230502
Provider Name (Legal Business Name): DENISE CANTORI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 YGNACIO VALLEY RD STE C103
WALNUT CREEK CA
94598-3382
US

IV. Provider business mailing address

10412 HARLOW CIR UNIT 45
SAN DIEGO CA
92108-1865
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-1474
  • Fax:
Mailing address:
  • Phone: 845-926-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number28745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: