IndividualActive
Derrick Cannon
NPI 1063057149 · Peer Specialist · San Bernardino, CA
Derrick Cannon is a Peer Specialist provider in San Bernardino, CA (NPI 1063057149).
Provider details
- NPI number
- 1063057149
- Entity type
- Individual
- Primary specialty
- Peer SpecialistOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
820 E Gilbert St
San Bernardino, CA 92415-1403
Phone: (909) 388-5644
Street-level locationGet directions
Mailing address
201 W Mill St
San Bernardino, CA 92408-1403
Registry dates
- Enumerated
- 2019-11-12
- Last updated
- 2019-11-26
Frequently asked questions
- What is Derrick Cannon's NPI number?
- Derrick Cannon's National Provider Identifier (NPI) is 1063057149, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Derrick Cannon's specialty?
- Derrick Cannon is listed in the NPPES registry with a primary specialty of Peer Specialist (Other Service Providers).
- Where is Derrick Cannon located?
- Derrick Cannon's practice location on file with NPPES is 820 E Gilbert St, San Bernardino, CA 92415-1403.
- What is Derrick Cannon's phone number?
- The practice phone number listed in the NPPES registry for Derrick Cannon is (909) 388-5644.
- Is Derrick Cannon's NPI active?
- Yes — Derrick Cannon's NPI (1063057149) is active in the NPPES registry as of the last update on 2019-11-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.