Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derrick Cannon I

Individual provider Peer Specialist · NPI 1063057149

Derrick Cannon I is a Peer Specialist in San Bernardino, California. Practices as a sole proprietor. Registered with an NPI since 2019.

In the registry since
2019
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Practice location Address checks out

820 E Gilbert St
San Bernardino, CA 92415-1403
Phone: (909) 388-5644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X

Record details

NPI number1063057149
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 12, 2019
Last updated in NPPESNovember 26, 2019

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