Provider Demographics
NPI:1013761444
Name:CABRERA-LARA, CLAUDIA YVETTE
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:YVETTE
Last Name:CABRERA-LARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1778 MISSION ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2472
Mailing Address - Country:US
Mailing Address - Phone:415-377-1152
Mailing Address - Fax:
Practice Address - Street 1:1663 MISSION ST STE 603
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2473
Practice Address - Country:US
Practice Address - Phone:415-240-4104
Practice Address - Fax:415-864-2773
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CCABRERAOtherIFR