Provider Demographics
NPI:1114436961
Name:VENEGAS, URIAH FOX (MD, IMF)
Entity Type:Individual
Prefix:
First Name:URIAH
Middle Name:FOX
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:MD, IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 LOS PINOS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2632
Mailing Address - Country:US
Mailing Address - Phone:805-895-9861
Mailing Address - Fax:
Practice Address - Street 1:1114 STATE ST STE 238
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2789
Practice Address - Country:US
Practice Address - Phone:805-895-9861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT124440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health