Provider Demographics
NPI:1558034645
Name:URIBE, ANDREA NATALY
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NATALY
Last Name:URIBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 CENTERPOINTE PKWY # 302
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1337
Mailing Address - Country:US
Mailing Address - Phone:805-346-8448
Mailing Address - Fax:805-346-8288
Practice Address - Street 1:2125 CENTERPOINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1337
Practice Address - Country:US
Practice Address - Phone:805-346-8448
Practice Address - Fax:805-346-8288
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2024-03-26
Deactivation Date:2022-01-31
Deactivation Code:
Reactivation Date:2024-03-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN