Provider Demographics
NPI:1679693766
Name:CABRERA, GILBERT JUAN (RN)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:JUAN
Last Name:CABRERA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 GISELLE LANE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206
Mailing Address - Country:US
Mailing Address - Phone:209-982-5920
Mailing Address - Fax:
Practice Address - Street 1:4122 GISELLE LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-6508
Practice Address - Country:US
Practice Address - Phone:209-982-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565185163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse