Provider Demographics
NPI:1982590626
Name:CABRERA, EVELYN BRIDGET
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:BRIDGET
Last Name:CABRERA
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 1:11134 S VERMONT AVE # C204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-1698
Mailing Address - Country:US
Mailing Address - Phone:310-672-3820
Mailing Address - Fax:310-672-3822
Practice Address - Street 1:405 W MANCHESTER BLVD STE A
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1196
Practice Address - Country:US
Practice Address - Phone:310-672-3820
Practice Address - Fax:310-672-3822
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local