Provider Demographics
NPI:1265641435
Name:CABRERA, JESSICA (APN)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6533
Mailing Address - Country:US
Mailing Address - Phone:956-289-7025
Mailing Address - Fax:956-289-7257
Practice Address - Street 1:1242 N 77 SUNSHINESTRIP
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8825
Practice Address - Country:US
Practice Address - Phone:956-289-7025
Practice Address - Fax:956-289-7257
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX724987163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138708613Medicaid
TX00R945OtherMEDICARE
TX138708611Medicaid
TX138708602Medicaid