Cannon, Melissa

Cannon, Melissa is an individual health care provider with primary practice located at 2950 International Blvd , Oakland CA 94601-2228. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Nutrition, Education, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Cannon, Melissa can be contacted via phone (510) 535-4463.

Contact Information

Primary practice address
2950 International Blvd Oakland CA 94601-2228
Phone: (510) 535-4463
Fax: (510) 535-4494
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 86009985 California

Profile Details

NPI number 1891038113
LBN Legal business name Cannon, Melissa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2013
Last updated Apr 4th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891038113 NPPES
California MEDICAID 1689863516
California Other HAP11743F
California MEDICAID FHC11743F

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