Provider Demographics
NPI:1265872360
Name:URIBE, NANCY (LMFT-113498)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:URIBE
Suffix:
Gender:
Credentials:LMFT-113498
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 DRACEA AVE.
Mailing Address - Street 2:A-11
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-3201
Mailing Address - Country:US
Mailing Address - Phone:951-284-9970
Mailing Address - Fax:
Practice Address - Street 1:2311 DRACEA AVE.
Practice Address - Street 2:A-11
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3201
Practice Address - Country:US
Practice Address - Phone:951-571-4689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CA113498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist