Provider Demographics
NPI:1114625829
Name:CABEZA, JANELLE MARIE
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:CABEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11252 ANABEL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-1943
Mailing Address - Country:US
Mailing Address - Phone:562-565-5733
Mailing Address - Fax:
Practice Address - Street 1:511 N BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5231
Practice Address - Country:US
Practice Address - Phone:714-795-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker