Individual
REBECCAH CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4699 OLD IRONSIDES DR STE 230, SANTA CLARA, CA 95054-1858
(408) 863-1705
Mailing address
19921 SUNNYSIDE DR N APT H204, SHORELINE, WA 98133-2712
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA61240594
WA
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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