Healthcare Provider Details

I. General information

NPI: 1639029739
Provider Name (Legal Business Name): GUSTAVO ARNULFO CABRERA AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E 4TH ST STE 116
SANTA ANA CA
92705-3916
US

IV. Provider business mailing address

2001 E 4TH ST STE 116
SANTA ANA CA
92705-3916
US

V. Phone/Fax

Practice location:
  • Phone: 714-824-8150
  • Fax: 714-824-8151
Mailing address:
  • Phone: 714-824-8150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT158126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: