Individual provider Active NPI

Jose Miguel Cabrera

  • Peer Specialist
  • East Palo Alto, CA
National Provider Identifier
1104220714
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
2277 University Ave
East Palo Alto, CA 94303-1717
Phone
(650) 853-3188
Fax
(650) 853-5928
NPI assigned
Oct 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

2277 University Ave
East Palo Alto, CA 94303-1717

Mailing address

2277 University Ave
East Palo Alto, CA 94303-1717
Phone (650) 853-3188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1104220714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 UNIVERSITY AVE",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031717",
            "telephone_number": "650-853-3188",
            "fax_number": "650-853-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 UNIVERSITY AVE",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031717",
            "telephone_number": "650-853-3188",
            "fax_number": "650-853-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.