Healthcare Provider Details

I. General information

NPI: 1295693224
Provider Name (Legal Business Name): LIBERTAD S. CABRERA-CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIBERTAD SANDOVAL CABRERA

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 LENREY AVE
EL CENTRO CA
92243-9211
US

IV. Provider business mailing address

2600 LENREY AVE
EL CENTRO CA
92243-9211
US

V. Phone/Fax

Practice location:
  • Phone: 760-996-3871
  • Fax:
Mailing address:
  • Phone: 760-996-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF12250055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: