Provider Demographics
NPI:1275975989
Name:URBANO, ALFRED GARCIA JR
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:GARCIA
Last Name:URBANO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 N BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-1913
Mailing Address - Country:US
Mailing Address - Phone:559-274-0299
Mailing Address - Fax:559-268-0473
Practice Address - Street 1:258 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1913
Practice Address - Country:US
Practice Address - Phone:559-274-0299
Practice Address - Fax:559-268-0473
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAASW-72297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator