Active NPI
Nicolas Dario Canon Salazar, MD
- Psychiatry Physician
- San Francisco, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A133438
- Practice address
- 490 Post St Ste 1043
San Francisco, CA 94102-1301 - Phone
- (925) 282-1778
- NPI assigned
- Jul 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116019347 | VA | |
| Psychiatry Physician | 2084P0800X | A133438 | CA | Primary |
Addresses
Primary practice location
490 Post St Ste 1043
San Francisco, CA 94102-1301
Mailing address
490 Post St Ste 1043
San Francisco, CA 94102-1301
Phone (925) 282-1778
Other practice location 1
7707 Austin Rd
Stockton, CA 95215-8312
Phone (209) 467-8083
Other practice location 2
6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815
Phone (925) 282-1778
Other practice location 3
1480 64th St Ste 150
Emeryville, CA 94608-2267
Phone (925) 282-1778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1480 64TH St
Suite 150
Emeryville, CA 94608-2267
Phone (925) 282-1778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A133438 | CA | MD | Psychiatry Physician |
| 0116019347 | VA | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- lifestancehealth.nicolascanonsalazar@148377.advancedmd-direct.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1306045281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 POST ST STE 1043",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941021301",
"telephone_number": "925-282-1778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 POST ST STE 1043",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941021301",
"telephone_number": "925-282-1778"
}
],
"practiceLocations": [
{
"address_1": "7707 Austin Rd",
"address_purpose": "LOCATION",
"city": "Stockton",
"state": "CA",
"postal_code": "952158312",
"country_code": "US",
"telephone_number": "209-467-8083",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6200 Wilshire Blvd Ste 1410",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900485815",
"country_code": "US",
"telephone_number": "925-282-1778",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1480 64th St Ste 150",
"address_purpose": "LOCATION",
"city": "Emeryville",
"state": "CA",
"postal_code": "946082267",
"country_code": "US",
"telephone_number": "925-282-1778",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANON SALAZAR",
"first_name": "NICOLAS",
"middle_name": "DARIO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-12",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0116019347",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A133438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.