Provider Demographics
NPI:1790102853
Name:CABRAL, IRMA (LMFT)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:CABRAL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42072 5TH ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2728
Mailing Address - Country:US
Mailing Address - Phone:951-483-8169
Mailing Address - Fax:951-263-4577
Practice Address - Street 1:42072 5TH ST STE 201B
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590
Practice Address - Country:US
Practice Address - Phone:951-483-8169
Practice Address - Fax:951-263-4577
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA106H000000X106H00000X
CA100392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health