Active NPI
Marcus Alden Cannon, LMFT
- Marriage & Family Therapist
- Riverside, CA
National Provider Identifier
1134420342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 82999
- Practice address
- 1405 Spruce St
Suite a
Riverside, CA 92507-2464 - Phone
- (951) 315-2693
- NPI assigned
- Nov 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 82999 | CA | Primary |
Addresses
Primary practice location
1405 Spruce St
Suite a
Riverside, CA 92507-2464
Mailing address
1405 Spruce St
Suite a
Riverside, CA 92507-2464
Phone (951) 315-2693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82999 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431648000000",
"number": "1134420342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 SPRUCE ST",
"address_2": "SUITE A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072464",
"telephone_number": "951-315-2693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 SPRUCE ST",
"address_2": "SUITE A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072464",
"telephone_number": "951-315-2693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "MARCUS",
"middle_name": "ALDEN",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-04",
"last_updated": "2015-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "82999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.