Healthcare Provider Details

I. General information

NPI: 1205609765
Provider Name (Legal Business Name): ERICA CABRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 W REDLANDS BLVD
REDLANDS CA
92373-4641
US

IV. Provider business mailing address

25590 PROSPECT AVE APT 44H
LOMA LINDA CA
92354-3155
US

V. Phone/Fax

Practice location:
  • Phone: 909-783-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT25492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: