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NPI Code Detail

MEDICARE: AREN LEIGH CANNON

MEDICARE: AREN LEIGH CANNON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystTX

General Provider Information

NPI Number : 1417618927
Entity Type Code : Individual
Provider Name (Legal Business Name) : AREN LEIGH CANNON
Provider Business Mailing Address
First Line : 21800 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3633
Country : US
Telephone Number : 818-245-2345
Fax Number :
Provider Business Practice Location Address
First Line : 140 HEIMER RD STE 710
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-5070
Country : US
Telephone Number : 210-819-9211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2022
Last Update Date : 01/06/2022

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Directions to “ AREN LEIGH CANNON ” Practice Location

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