Provider Demographics
NPI:1013479823
Name:CABRERA, REBECCA (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:RENTERIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:735 W END WAY APT 305
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2550
Mailing Address - Country:US
Mailing Address - Phone:530-249-2145
Mailing Address - Fax:
Practice Address - Street 1:4000 CIVIC CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4151
Practice Address - Country:US
Practice Address - Phone:628-877-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA23292225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician