Individual provider Active NPI

Rebecca L Cannon, MFT

  • Marriage & Family Therapist
  • San Leandro, CA
National Provider Identifier
1427105691
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC15809 Issued in CA
Practice address
13666 E 14TH St
San Leandro, CA 94578-2538
Phone
(510) 357-5515
Fax
(510) 357-5112
NPI assigned
Jan 3, 2007
Last updated
Jun 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC15809 CA Primary

Addresses

Primary practice location

13666 E 14TH St
San Leandro, CA 94578-2538

Mailing address

510 16TH St
Oakland, CA 94612-1520
Phone (510) 357-5515

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

LicenseStateTypeSpecialty
MFC15809CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Girls Incorporated of Alameda County Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1427105691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121520",
            "telephone_number": "510-357-5515",
            "fax_number": "510-357-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13666 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782538",
            "telephone_number": "510-357-5515",
            "fax_number": "510-357-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC15809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.