Provider Demographics
NPI:1730400375
Name:KARRIS, BIANCA CABRERA (MD)
Entity type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:CABRERA
Last Name:KARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BIANCA
Other - Middle Name:BARADI
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8775 AERO DR STE 238
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1756
Mailing Address - Country:US
Mailing Address - Phone:855-629-7272
Mailing Address - Fax:
Practice Address - Street 1:8775 AERO DR STE 238
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1756
Practice Address - Country:US
Practice Address - Phone:855-629-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56225-0202084P0800X
CA1471242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA147124OtherCALIFORNIA MEDICAL LICENSE