Provider Demographics
NPI:1881224756
Name:CAYANAN, JOSEPH LOS BANEZ
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LOS BANEZ
Last Name:CAYANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 E CHASE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-6300
Mailing Address - Country:US
Mailing Address - Phone:619-647-6157
Mailing Address - Fax:
Practice Address - Street 1:260 E CHASE AVE STE 204
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6300
Practice Address - Country:US
Practice Address - Phone:619-647-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist