Healthcare Provider Details

I. General information

NPI: 1356627558
Provider Name (Legal Business Name): AIMEE CABRERA PESTANO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 E TURMONT ST
CARSON CA
90746-3814
US

IV. Provider business mailing address

1152 E TURMONT ST
CARSON CA
90746-3814
US

V. Phone/Fax

Practice location:
  • Phone: 310-735-3553
  • Fax: 310-735-3553
Mailing address:
  • Phone: 310-735-3553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1011138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: