KODY CABREROS (NPI# 1679070072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679070072 |
| Entity Type | Individual |
| Full Name | KODY CABREROS |
| Practice Address |
685 Coleman Ave Ste 20 San Jose CA 95110 |
| Mailing Address |
325 Distel Cir Los Altos CA 94022-1408 |
| Practice Telephone | 4082176404 |
| Mailing Telephone | 9254839907 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2020-06-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95008393 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 195 E Virginia St, San Jose, CA 951125844 | 4089185500 |
| Street Address |
685 COLEMAN AVE STE 20 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356876064 | Clarissa Sherrill Chan | Physician Assistant | 685 Coleman Ave Ste 20, San Jose, CA 95110 | 2017-05-01 |
| 1093244246 | Diem-thuy Thi Le | Physician Assistant | 685 Coleman Ave Ste 20, San Jose, CA 95110-2011 | 2017-06-09 |
| 1962931600 | Victoria Perez | Nurse Practitioner | 685 Coleman Ave Ste 20, San Jose, CA 95110-2000 | 2017-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366895666 | Lifemoves - Autumn Satellite Clinic | Case Management | 263 N Autumn St, San Jose, CA 95110 | 2016-07-21 |
| 1487067278 | Catholic Charities of Scc | Community/Behavioral Health | 921 S 1st St, San Jose, CA 95110 | 2014-06-09 |
| 1871855916 | Act for Mental Health, Inc | Psychologist | 441 Park Avenue, San Jose, CA 95110 | 2012-06-14 |
| 1730451238 | Jackson Huang | Nurse Practitioner | 685 Coleman Ave, San Jose, CA 95110 | 2012-01-31 |
| 1104000405 | Kaitlyn Brownell | Case Manager/Care Coordinator | 150-a S. Autumn St., San Jose, CA 95110 | 2007-12-21 |
| 1760685218 | Sharon Iwen Wang | Psychologist | 2033 Gateway Pl Fl 5, San Jose, CA 95110 | 2007-06-11 |
| 1528192036 | Wanda Broadie Alexander | Social Worker | 441 Park Ave, San Jose, CA 95110 | 2007-03-15 |
| 1750442208 | Mario Ricardo Ponce | Counselor | 70 West Hedding Street, County of Santa Clara, San Jose, CA 95110 | 2006-12-12 |
| 1467426882 | Lannie S. Zarate-reyes D.d.s., Inc. | Dentist | 579-10 Coleman Avenue, San Jose, CA 95110 | 2006-02-14 |
| 1194374827 | Little Spirits LLC | Clinic/Center | 77 N Almaden Ave, Ste #102, San Jose, CA 95110 | 2019-09-05 |
| Find all providers in zip 95110 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565738 | Lena Kil | Nurse Practitioner | 3680 Greenlee Dr Apt 4, San Jose, CA 95117-1469 | 2020-10-09 |
| 1740893858 | Esther Kiang | Nurse Practitioner | 1072 E Santa Clara St, San Jose, CA 95116-2245 | 2020-08-28 |
| 1902419575 | Leonard Iskander | Nurse Practitioner | 1146 Summerpark Ct, San Jose, CA 95132-2944 | 2020-08-25 |
| 1760004055 | Destiny Ann Brewer | Nurse Practitioner | 4735 Hamilton Ave # 80, San Jose, CA 95130-1769 | 2020-05-11 |
| 1841825148 | Marta Anna Sivarajah | Nurse Practitioner | 255 N. White Rd., San Jose, CA 95127-1966 | 2020-03-06 |
| 1114567500 | Sabine Dorothea Haas | Nurse Practitioner | 1879 Lundy Ave Ste 233, San Jose, CA 95131-1881 | 2020-01-14 |
| 1861033870 | Jessica Gutierrez | Nurse Practitioner | 635 S 11th St Apt 14, San Jose, CA 95112-2343 | 2019-10-01 |
| 1124589379 | Yvonne Ndeh | Nurse Practitioner | 418 Shadowgraph Dr, San Jose, CA 95110-3564 | 2019-03-29 |
| 1588139661 | Vicky Chi Lin | Nurse Practitioner | 100 Oak St Rm F-3, San Jose, CA 95110-2817 | 2018-10-04 |
| 1851884381 | Anh Tuan Huynh | Nurse Practitioner | 3100 Rubino Dr Apt 310, San Jose, CA 95125-6369 | 2018-06-09 |
| Find all providers in SAN JOSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.