MEDICARE: KIRSTEN JEAN A 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	225100000X	Physical Therapist		CA

General Provider Information

NPI Number	:	1841047958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN JEAN A CABRERA

Provider Business Mailing Address
First Line	:	12235 EAGLE RIDGE WAY
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-3844
Country	:	US
Telephone Number	:	818-585-9218
Fax Number	:

Provider Business Practice Location Address
First Line	:	25949 THE OLD RD
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91381-1714
Country	:	US
Telephone Number	:	661-254-0077
Fax Number	:

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

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	05/06/2024

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Directions to “ KIRSTEN JEAN A CABRERA ” Practice Location

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