Provider Demographics
NPI:1093453060
Name:CABRAL, ANYSSA MONIQUE (DPT)
Entity Type:Individual
Prefix:
First Name:ANYSSA
Middle Name:MONIQUE
Last Name:CABRAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 WOODGROVE RD
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1028
Mailing Address - Country:US
Mailing Address - Phone:805-317-1937
Mailing Address - Fax:
Practice Address - Street 1:957 FAULKNER RD STE 105
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-9129
Practice Address - Country:US
Practice Address - Phone:805-265-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist