STAR CANNON CADC II, ICADC, MATS
NPI 1265508311
Peer Specialist in Carmichael, CA

Q: What is Star Cannon's NPI number?

The NPI number for Star Cannon is 1265508311. It was assigned to this individual provider in the NPPES registry on November 28, 2006.

Q: What is Star Cannon's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Star Cannon was last updated on May 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 28, 2006

3637 MISSION AVE BLDG B, CARMICHAEL, CA 95608(916) 485-4175 Get Directions Write a Review

NPPES record last updated: May 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 23, 2025, Nov 23, 2022, May 19, 2020 (3 updates tracked since 2020).

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About Star Cannon Cadc Ii, Icadc, Mats NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STAR CANNON CADC II, ICADC, MATS (NPI 1265508311) is an individual peer specialist in Carmichael, California and active in the NPI registry since November 2006. She maintains a secondary practice location in North Highlands.

NPPES Registry Identity

NPI1265508311

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameSTAR CANNONCredential: CADC II, ICADC, MATS

Location Address3637 MISSION AVE BLDG BCarmichael, CA 95608-2946

Mailing Address1329 Howe Ave Ste 201Sacramento, CA 95825-3363 · (916) 333-3800

Phone(916) 485-4175

Sole ProprietorNo

Enumeration DateNovember 28, 2006

Last NPPES UpdateMay 23, 20253 updates tracked since enumeration

NPPES CertifiedMay 23, 2025

✔ NPI 1265508311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedCommunity Health WorkerTaxonomy 172V00000X

3637 MISSION AVE BLDG B, Carmichael, CA 95608

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Secondary Practice Location 1

Location 13628 Madison Ave Ste 7North Highlands, CA 95660-5070 · Phone (916) 388-3231

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXANDRA CURTIS

Counselor