Active NPI
Steven Cannon
- Addiction (Substance Use Disorder) Counselor
- Palm Desert, CA
National Provider Identifier
1881022663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- C0911291135
- Practice address
- 74923 Hovley LN E
Palm Desert, CA 92260-1927 - Phone
- (760) 770-2257
- Fax
- (760) 770-2240
- NPI assigned
- Oct 14, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C0911291135 | CA | Primary |
Addresses
Primary practice location
74923 Hovley LN E
Palm Desert, CA 92260-1927
Mailing address
7664 S US Highway 1 Ste 100
Port St Lucie, FL 34952-2315
Phone (772) 310-3075
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 |
|---|---|---|---|
| C0911291135 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1881022663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7664 S US HIGHWAY 1 STE 100",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349522315",
"telephone_number": "772-310-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74923 HOVLEY LN E",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922601927",
"telephone_number": "760-770-2257",
"fax_number": "760-770-2240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "STEVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-14",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "C0911291135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.