Provider Demographics
NPI:1881966307
Name:URENA, NANCY (MFTI)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W. VICTORIA STREET SUITE F & G
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220
Mailing Address - Country:US
Mailing Address - Phone:310-669-9510
Mailing Address - Fax:310-669-9501
Practice Address - Street 1:901 W. VICTORIA ST SUITE F & G
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220
Practice Address - Country:US
Practice Address - Phone:310-669-9510
Practice Address - Fax:310-669-9501
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health