Jeanette Cabanilla, PPS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

250084946 Issued in CA

Practice address

1654 Buckman Springs Rd
Campo, CA 91906-2004

Phone

(619) 473-9022

NPI assigned

Dec 2, 2025

Last updated

Dec 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeanette De la Rosa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1417819160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 BUCKMAN SPRINGS RD",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "919624005",
            "telephone_number": "619-473-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 BUCKMAN SPRINGS RD",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919062004",
            "telephone_number": "619-473-9022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24875 Potrero Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Potrero",
            "state": "CA",
            "postal_code": "919634110",
            "country_code": "US",
            "telephone_number": "619-473-9022 x812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABANILLA",
        "first_name": "JEANETTE",
        "credential": "PPS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "250084946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "DE LA ROSA",
            "credential": "PPS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matteson Brickner, RADT
• Brandon Scott Brown, M.D., PH.D.
• Joshua Steven Bruce, CPSS
• Bryan S Burke, RADT
• Corinna D. Bynum, RN
• Chantal Camarena, RADT
• Ann Carter, RN
• Corey Adam Cartwright, RADT
• Centro de Salud de la Comunidad de San Ysidro Inc (San Ysidro Health Pharmacy Mountain Health)
• Centro de Salud de la Comunidad de San Ysidro, Inc. (San Ysidro Health Mountain Health Family Medicine)

• School Psychologist in Campo, CA
• Providers in Campo, CA by specialty
• School Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.