Provider Demographics
NPI:1922555986
Name:URIBE, OSCAR DAVID (BA)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:DAVID
Last Name:URIBE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 COTTONWOOD ST
Mailing Address - Street 2:#220
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4358
Mailing Address - Country:US
Mailing Address - Phone:925-848-7611
Mailing Address - Fax:
Practice Address - Street 1:724 COTTONWOOD ST
Practice Address - Street 2:#220
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4358
Practice Address - Country:US
Practice Address - Phone:925-848-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst