Provider Demographics
NPI:1477267425
Name:URIAS, ANGIE ESTHER
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:ESTHER
Last Name:URIAS
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 1:348 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-2204
Mailing Address - Country:US
Mailing Address - Phone:661-910-2472
Mailing Address - Fax:
Practice Address - Street 1:1001 TOWER WAY STE 140
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1586
Practice Address - Country:US
Practice Address - Phone:661-634-9877
Practice Address - Fax:661-864-0198
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)