Healthcare Provider Details

I. General information

NPI: 1184985186
Provider Name (Legal Business Name): VICTORIA C CABRAL APN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 N LOGAN ST UNIT 101
DENVER CO
80203-2309
US

IV. Provider business mailing address

2725 W 39TH AVE
DENVER CO
80211-2039
US

V. Phone/Fax

Practice location:
  • Phone: 720-897-8617
  • Fax: 720-796-8472
Mailing address:
  • Phone: 774-644-7687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.1669617
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0995753.NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: