Provider Demographics
NPI:1245930320
Name:CABRERO, ALENA MARIE (MA, AMFT)
Entity type:Individual
Prefix:
First Name:ALENA
Middle Name:MARIE
Last Name:CABRERO
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 STANFORD ST APT F
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-6874
Mailing Address - Country:US
Mailing Address - Phone:917-767-9059
Mailing Address - Fax:
Practice Address - Street 1:1524 STANFORD ST APT F
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-6874
Practice Address - Country:US
Practice Address - Phone:917-767-9059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist