Provider Demographics
NPI:1184906349
Name:CABILES, FERNANDO JR
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:CABILES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:CABILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1911 CAMINO DE LA COSTA
Mailing Address - Street 2:APARTMENT 408
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5452
Mailing Address - Country:US
Mailing Address - Phone:310-421-8587
Mailing Address - Fax:
Practice Address - Street 1:1911 CAMINO DE LA COSTA
Practice Address - Street 2:APARTMENT 408
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5452
Practice Address - Country:US
Practice Address - Phone:310-421-8581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist