Provider Demographics
NPI:1053515999
Name:KANANEN, YOLANDA CESILA (AUDIOPROSTHOLOGIST)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:CESILA
Last Name:KANANEN
Suffix:
Gender:F
Credentials:AUDIOPROSTHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 GREGORY LN STE 202
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2813
Mailing Address - Country:US
Mailing Address - Phone:925-674-8621
Mailing Address - Fax:
Practice Address - Street 1:425 GREGORY LN STE 202
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2813
Practice Address - Country:US
Practice Address - Phone:925-674-8621
Practice Address - Fax:925-674-0874
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2944237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist