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Individual
MELISSA CANNON
Active
Individual
MELISSA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
86009985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689863516
—
CA
05
—
FHC11743F
—
CA
01
—
HAP11743F
SOFP
CA
Enumeration date
04/04/2013
Last updated
04/04/2013
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