Healthcare Provider Details

I. General information

NPI: 1881774602
Provider Name (Legal Business Name): JANICE K CABRERA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 DALY ST
LOS ANGELES CA
90031-3309
US

IV. Provider business mailing address

479 S HEPNER AVE
COVINA CA
91723-2920
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN269948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: