Individual
MRS. VICTORIA CANNON CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
71400000X
Contact information
Practice address
622 10TH ST, HERMOSA BEACH, CA 90254-3930
(310) 955-0900
Mailing address
622 10TH ST, HERMOSA BEACH, CA 90254-3930
(310) 955-0900
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71400000X
NBHWC
CA
Enumeration date
01/18/2022
Last updated
01/18/2022
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