STACEY CANNON (NPI# 1013217132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013217132 |
| Entity Type | Individual |
| Full Name | STACEY CANNON |
| Practice Address |
2008 Pacific Ave Long Beach CA 90806-4610 |
| Practice Telephone | 5625910011 |
| Practice Fax Number | 5625910071 |
| Mailing Telephone | 5625910011 |
| Mailing Fax Number | 5625910071 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700304565 | Stacey Richelle Cannon | Massage Therapist | 32 Market Place, Big Sky, MT 59716 | 2017-08-31 |
| 1497027197 | Stacey L Cannon | Registered Nurse | 5454 E State St, Hermitage, PA 16148-9441 | 2012-01-27 |
| 1013246859 | Stacey Cannon | Speech-Language Pathologist | 5316 Trail Lake Dr, Fort Worth, TX 76133-1931 | 2009-12-07 |
| Street Address |
2008 PACIFIC AVE |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90806-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366655409 | Juanita Antiporda | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2007-05-07 |
| 1225376767 | Leonard William Olivas | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2013-01-17 |
| 1154668671 | Stanford Jackson | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2013-01-04 |
| 1134470073 | Willie Daniel Ducksworth | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2012-10-01 |
| 1396012704 | David Wayne Talbott | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2011-11-30 |
| 1336422179 | Georgina Patricia Alvarez | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2011-09-27 |
| 1861788135 | Duke Cannon | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2011-06-24 |
| 1831401140 | Janeth Ortiz | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2010-07-02 |
| 1477865715 | Rosa Moreno | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2010-07-01 |
| 1487970414 | Harry Hill Jr. | Counselor | 2008 Pacific Ave, Long Beach, CA 90806-4610 | 2010-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437624913 | Blanca C Gonzalez | Community Health Worker | 2600 Redondo Ave 6th Floor, Long Beach, CA 90806 | 2018-10-10 |
| 1780192740 | New Healthcare Supplies Inc | Durable Medical Equipment & Medical Supplies | 1001 E Pacific Coast Hwy Ste 117, Long Beach, CA 90806 | 2018-01-11 |
| 1265946586 | California Sleep Neurology Organization for Wellness | Clinic/Center | 2651 Elm Avenue, Suite 205, Long Beach, CA 90806 | 2017-11-22 |
| 1053820613 | Magnolia Cedeno-moreno | Counselor | 2600 Redondo Ave. 3rd Fl, Long Beach, CA 90806 | 2017-09-27 |
| 1144747569 | Kimberly Savanannah Rodriguez | Social Worker | 2600 Redondo Ave., 6th Floor, Long Beach, CA 90806 | 2017-08-25 |
| 1194257170 | Sarah Mahmood | Pediatrics | The Children's Clinic, 2360 Pacific Ave, Long Beach, CA 90806 | 2017-03-29 |
| 1801334784 | Denise Harbor | Student in an Organized Health Care Education/Training Program | 721 East 28th Street, Suite 401, Long Beach, CA 90806 | 2017-02-10 |
| 1083152839 | Kim Vu | Student in an Organized Health Care Education/Training Program | 701 East 28th Street Ste. 416, Long Beach, CA 90806 | 2017-02-01 |
| 1568910719 | Andrea Corona | Community Health Worker | 850 W Wardlow Rd, Long Beach, CA 90806 | 2016-09-16 |
| 1235589110 | Sarah Keihany-yazdy | Nurse Practitioner | 2000 San Gabriel Ave, Long Beach, CA 90806 | 2016-06-21 |
| Find all providers in zip 90806 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114534526 | Lakeysher Swantima Whitfeld | Counselor | 1225 E 3rd St Apt A, Long Beach, CA 90802-3670 | 2020-09-29 |
| 1467061457 | Alex Glowacki | Counselor | 212 Euclid Ave Apt 102, Long Beach, CA 90803-6033 | 2020-07-27 |
| 1154960441 | Asopaepae Ropeti Mulitauaopele | Counselor | 2720 E 56th St, Long Beach, CA 90805-5104 | 2020-01-03 |
| 1689212029 | Brian Scott Becher | Counselor | 4427 E Anaheim St # B, Long Beach, CA 90804-3115 | 2019-12-17 |
| 1134774912 | Asucena Leon | Counselor | 2140 W Wardlow Rd Apt 3, Long Beach, CA 90810-2059 | 2019-08-07 |
| 1649746215 | Cassandra Whitney Dewey | Counselor | 2120 W. Williams Street, Long Beach, CA 90810 | 2018-10-22 |
| 1598240442 | Elle Whitney Anzalone | Counselor | 6502 E Wardlow Rd, Long Beach, CA 90808-4137 | 2018-09-26 |
| 1114404407 | Anthony Sison | Counselor | 1358 Ximeno Ave, Long Beach, CA 90804-3045 | 2018-07-19 |
| 1073026738 | Latrisha S. Stewart | Counselor | 2120 W Williams St Unit 31, Long Beach, CA 90810-3636 | 2017-11-15 |
| 1316462484 | Kathlyn Pearl Parlet | Counselor | 351 E. 6th. Street, Long Beach, CA 90802 | 2017-08-09 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90806 |
Please comment or provide details below to improve the information on STACEY CANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.