Tucker Croxall Cannon LCSW

NPI 1205969623 - Social Worker - 1041C0700X

NPI Details
NPI 1205969623
Gender Male
Enumeration Date 03/14/2007
Last Updated 11/02/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
2046 ALLEN AVE RM 100
ALTADENA CA, 91001-3424, US
Phone (626) 660-9419
Business Location
204 MAIN ST. SUITE 4091
NEWPORT BEACH CA, 92661-9998, US
Phone (949) 244-9982
Taxonomy Code 1041C0700X
License State California
License Number 28707
Remove 1205969623 NPI Number

According to our database, Mr. Tucker Croxall Cannon LCSW NPI is 1205969623, taxonomy code is 1041C0700X and license number is 28707, license state is located at California. Tucker Croxall Cannon LCSW physically located at 2046 Allen Ave Rm 100, Altadena CA, 91001-3424. NPI Number Tucker Croxall Cannon LCSW has the Individual type.

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1205969623 NPI number is provided on an as is basis without warranty of any kind. 1205969623 is maintained by the National Plan & Provider Enumeration System. The contents of Tucker Croxall Cannon LCSW are for informational purposes only.