Provider Demographics
NPI:1528183274
Name:CABRERA, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CABRERA
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:PO BOX 9351
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93791-9351
Mailing Address - Country:US
Mailing Address - Phone:559-266-9581
Mailing Address - Fax:559-498-0507
Practice Address - Street 1:539 N VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-3419
Practice Address - Country:US
Practice Address - Phone:559-266-9581
Practice Address - Fax:559-498-0507
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1669559878Medicare ID - Type Unspecified