Doctor Name: | DR. RIGOVERTO CABRERA BRICENO |
NPI Number: | 1003824103 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY13413 |
Business Practice Address: | 3737 Martin Luther King Jr Blvd #385 Lynwood, CA - 902623513 |
Business Phone Number: | 3106355481 |
Business Fax Number: | 3106359512 |
Mailing Address: | 3737 Martin Luther King Jr Blvd, #385 LYNWOOD |
State: | CA |
Postal Code: | 902623513 |
Phone Number: | 3106355481 |
Fax Number: | 3106359512 |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY13413 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |