Active NPI
Cassandra Cannon, PH.D.
- Psychologist
- Sacramento, CA
National Provider Identifier
1679053250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY24315
- Practice address
- 3626 Fair Oaks Blvd Ste 100
Sacramento, CA 95864-7200 - Phone
- (858) 367-3368
- NPI assigned
- Aug 14, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY24315 | CA | Primary |
Addresses
Primary practice location
3626 Fair Oaks Blvd Ste 100
Sacramento, CA 95864-7200
Mailing address
3626 Fair Oaks Blvd Ste 100
Sacramento, CA 95864-7200
Phone (858) 367-3368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 7, 2025 through Sep 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24315 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778889600000",
"number": "1679053250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 FAIR OAKS BLVD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958647200",
"telephone_number": "858-367-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 FAIR OAKS BLVD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958647200",
"telephone_number": "858-367-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "CASSANDRA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-14",
"last_updated": "2026-05-16",
"certification_date": "2026-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY24315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.