Provider Demographics
NPI:1205023371
Name:ULIBARRI, ANN M (LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:ULIBARRI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3373 WHITEMARSH LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-7136
Mailing Address - Country:US
Mailing Address - Phone:707-494-2497
Mailing Address - Fax:720-384-1480
Practice Address - Street 1:419 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4602
Practice Address - Country:US
Practice Address - Phone:707-494-2497
Practice Address - Fax:720-384-1480
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46583106H00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No251S00000XAgenciesCommunity/Behavioral Health