Healthcare Provider Details

I. General information

NPI: 1396609152
Provider Name (Legal Business Name): BIANCA CABELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 HUMBOLDT AVE
CHOWCHILLA CA
93610-3199
US

IV. Provider business mailing address

3536 SAN JUAN DR
MADERA CA
93637-6714
US

V. Phone/Fax

Practice location:
  • Phone: 559-665-1331
  • Fax:
Mailing address:
  • Phone: 559-232-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: