Star Cannon, CADC II, ICADC, MATS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

3637 Mission Ave BLDG B
Carmichael, CA 95608-2946

Phone

(916) 485-4175

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sustainable Wellness Solutions

  • Voluntary or Charitable Agency
  • Sacramento, CA
  • NPI 1184758864
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1265508311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 HOWE AVE STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253363",
            "telephone_number": "916-333-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 MISSION AVE BLDG B",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082946",
            "telephone_number": "916-485-4175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3628 Madison Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "North Highlands",
            "state": "CA",
            "postal_code": "956605070",
            "country_code": "US",
            "telephone_number": "916-388-3231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "STAR",
        "credential": "CADC II, ICADC, MATS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra I Caldwell, AU.D
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• Can-Al Medical Supplies
• Monique Canty, VN254227
• Capitol Clinical Neuroscience, Inc.
• Capitol Health Care, LLC.
• Krista Cardenas
• Donna Marie Cardoza-Costa

• Peer Specialist in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.