MEDICARE: JANET HULDAH CANNON LCSW

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
1	1041C0700X	Clinical Social Worker	LCSW26303	CA

General Provider Information

NPI Number	:	1033069364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET HULDAH CANNON LCSW

Provider Business Mailing Address
First Line	:	2034 OAKLAND AVE
Second Line	:
City	:	PIEDMONT
State	:	CA
Zip	:	94611-3737
Country	:	US
Telephone Number	:	510-846-7272
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 OAKLAND AVE
Second Line	:
City	:	PIEDMONT
State	:	CA
Zip	:	94611-3737
Country	:	US
Telephone Number	:	510-846-7272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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