Provider Demographics
NPI:1598011454
Name:CABRERA, DENA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39506 W. DAISY MOUNTAIN DR., UNIT 122, BOX 147
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-6007
Mailing Address - Country:US
Mailing Address - Phone:602-562-7447
Mailing Address - Fax:623-551-8306
Practice Address - Street 1:42104 N VENTURE DR STE 102
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3823
Practice Address - Country:US
Practice Address - Phone:602-562-7447
Practice Address - Fax:623-551-8306
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3377103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3377OtherARIZONA STATE BOARD