Healthcare Provider Details

I. General information

NPI: 1164393658
Provider Name (Legal Business Name): DESIREA CABANAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7285 QUILL DR
DOWNEY CA
90242-2001
US

IV. Provider business mailing address

7285 QUILL DR
DOWNEY CA
90242-2001
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-8826
  • Fax:
Mailing address:
  • Phone: 323-226-8826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: