Provider Demographics
NPI:1508895848
Name:CABRERA, VANESSA MICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:MICHELLE
Last Name:CABRERA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 W. LOWER BUCKEYE RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353
Mailing Address - Country:US
Mailing Address - Phone:623-215-0009
Mailing Address - Fax:623-478-1621
Practice Address - Street 1:9820 W. LOWER BUCKEYE RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353
Practice Address - Country:US
Practice Address - Phone:623-215-0009
Practice Address - Fax:623-478-1621
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1559152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist