Provider Demographics
NPI:1679460471
Name:URIBE, PAOLA MONTSERRAT
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:MONTSERRAT
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 1:4199 FLAT ROCK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-7116
Mailing Address - Country:US
Mailing Address - Phone:909-372-9949
Mailing Address - Fax:
Practice Address - Street 1:4199 FLAT ROCK DR STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-7116
Practice Address - Country:US
Practice Address - Phone:909-372-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist