MEDICARE: ANTONIO CABRERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	91596	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	104100000X	Social Worker	91596	CA
4	1041C0700X	Clinical Social Worker	91596	CA

General Provider Information

NPI Number	:	1073031522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIO CABRERA

Provider Business Mailing Address
First Line	:	1911 WILLIAMS DR
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93036-2612
Country	:	US
Telephone Number	:	805-981-9270
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 WILLIAMS DR
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93036-2612
Country	:	US
Telephone Number	:	805-981-9270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	03/16/2026

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Directions to “ ANTONIO CABRERA ” Practice Location

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