Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1013535806 |
---|---|
Provider Name | Eduardo Cabrera |
First Address | Bloomington, CA 92316-2734 |
Second Address | Rancho Cucamonga, CA 91730-4554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2020 |
Last Update Date | 08/07/2020 |