Provider Demographics
NPI:1740951920
Name:CABRERA, KRISHA (MS)
Entity type:Individual
Prefix:
First Name:KRISHA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8312 JOSEPH CARY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-2409
Mailing Address - Country:US
Mailing Address - Phone:725-218-7900
Mailing Address - Fax:
Practice Address - Street 1:5584 S FORT APACHE RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7657
Practice Address - Country:US
Practice Address - Phone:702-296-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2024-10-30
Deactivation Date:2022-08-24
Deactivation Code:
Reactivation Date:2024-10-02
Provider Licenses
StateLicense IDTaxonomies
NV07808I101YA0400X
NVCI5452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)