Provider Demographics
NPI:1710258736
Name:CABRAL, ABIGAIL VICENCIO (PT,CKTP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:VICENCIO
Last Name:CABRAL
Suffix:
Gender:F
Credentials:PT,CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18805 COX AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4183
Mailing Address - Country:US
Mailing Address - Phone:408-379-8141
Mailing Address - Fax:408-379-8196
Practice Address - Street 1:18805 COX AVE STE 110
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4183
Practice Address - Country:US
Practice Address - Phone:408-379-8141
Practice Address - Fax:408-379-8196
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist