Provider Demographics
NPI:1639050388
Name:CABRERA, JUANITA (MSN, FNP-BC, RN,CNOR)
Entity type:Individual
Prefix:MISS
First Name:JUANITA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MSN, FNP-BC, RN,CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 GUY ST APT 10
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3755
Mailing Address - Country:US
Mailing Address - Phone:619-616-8637
Mailing Address - Fax:
Practice Address - Street 1:1627 GUY ST APT 10
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3755
Practice Address - Country:US
Practice Address - Phone:619-616-8637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily