Provider Demographics
NPI:1902114812
Name:CABRERA JIMENEZ, CIBELL (SW)
Entity Type:Individual
Prefix:
First Name:CIBELL
Middle Name:
Last Name:CABRERA JIMENEZ
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO JARDINES DE GUAYAMA
Mailing Address - Street 2:EDIFICIO E APTO 501
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-594-1691
Mailing Address - Fax:
Practice Address - Street 1:1549 CALLE ALDA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2709
Practice Address - Country:US
Practice Address - Phone:787-594-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical