Individual
MRS. BIANCA CANNAVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD-CCC-SLP
Contact information
Practice address
1040 WYCLIFFE, IRVINE, CA 92602-1222
(909) 762-1465
Mailing address
935 CONTESSA, IRVINE, CA 92620-1726
(909) 762-1465
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12007
CA
390200000X
Student in an Organized Health Care Education/Training Program
12007
CA
Other
Enumeration date
02/07/2018
Last updated
02/05/2021
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