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Mr. John David Cannon
Mental Health Counselor in Oakland, California
NPI 1649514621

John David Cannon is a Mental Health Counselor based in Oakland, CA and is specialized in Mental Health. John David Cannon practices in Oakland, CA. The NPI Number for John David Cannon is 1649514621 and holds a License No. (California).

The current practice location address for John David Cannon is 280 17Th St, Oakland, CA and can be reached out via phone at 510-238-5020 and via fax at 510-238-5020.

Location: 280 17Th St, Oakland, CA, 94612-4124
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649514621
Provider Name
John David Cannon
Credential
Provider Entity Type
Individual
Gender
Male
Address
280 17Th St, Oakland, CA, 94612-4124
Phone Number
510-238-5020
Fax Number
510-238-5020
Provider Enumeration Date
11/15/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1411033663 01 CA EMPLOYER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
280 17Th St
City
Oakland
State
California
Zip
94612-4124
Phone Number
510-238-5020
Fax Number
510-238-5020
person
Provider Business Mailing Address Details
Address
280 17Th St
City
Oakland
State
California
Zip
94612-4124
Phone Number
510-238-5020
Fax Number
510-238-5020
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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