John Jacob Cannell, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C37547 Issued in CA

Practice address

1411 Marsh St Ste 203
San Luis Obispo, CA 93401-2968

Phone

(805) 439-2569

Fax

(805) 439-1073

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1114979374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 MARSH ST STE 203",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012968",
            "telephone_number": "805-439-2569",
            "fax_number": "805-439-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MARSH ST STE 203",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012968",
            "telephone_number": "805-439-2569",
            "fax_number": "805-439-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNELL",
        "first_name": "JOHN",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C37547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Marie Campos
• Holly Campuzano
• Marina Canella
• Craig Wesley Canfield, M.D.
• Gregory Scott Canfield, M.D., PH.D.
• Trena Marie Cannon, RN
• Ashley Cansler
• Glen Andrew Canter Jr., LPT
• Kerensa Cantieri, LVN
• Jessica Preston Lambert Cantley, M.S., M.A.

• Psychiatry Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.