Healthcare Provider Details

I. General information

NPI: 1548639446
Provider Name (Legal Business Name): JESSICA CABRERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 283
SIERRA MADRE CA
91025-0283
US

IV. Provider business mailing address

PO BOX 283
SIERRA MADRE CA
91025-0283
US

V. Phone/Fax

Practice location:
  • Phone: 626-340-1457
  • Fax:
Mailing address:
  • Phone: 626-340-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number127201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: