Provider Demographics
NPI:1508116393
Name:URBINA, EFREN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:EFREN
Middle Name:
Last Name:URBINA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 ENCINAL CANYON RD
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-2404
Mailing Address - Country:US
Mailing Address - Phone:818-889-0260
Mailing Address - Fax:818-707-0364
Practice Address - Street 1:427 ENCINAL CANYON RD
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-2404
Practice Address - Country:US
Practice Address - Phone:818-889-0260
Practice Address - Fax:818-707-0364
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041S0200X
CA910141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool