Provider Demographics
NPI:1770343758
Name:CEVALLOS, PRISCILA CANALES (MD)
Entity type:Individual
Prefix:DR
First Name:PRISCILA
Middle Name:CANALES
Last Name:CEVALLOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRISCILA
Other - Middle Name:
Other - Last Name:CANALES CEVALLOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:770 WELCH RD STE 400
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1515
Mailing Address - Country:US
Mailing Address - Phone:650-723-5824
Mailing Address - Fax:
Practice Address - Street 1:770 WELCH RD STE 400
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1515
Practice Address - Country:US
Practice Address - Phone:650-723-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program