Provider Demographics
NPI:1912769415
Name:URBINA, CEILO
Entity Type:Individual
Prefix:
First Name:CEILO
Middle Name:
Last Name:URBINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CEILO
Other - Middle Name:
Other - Last Name:URBINA-GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 GLYNBROOK ST N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-5796
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 GLYNBROOK ST N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-5796
Practice Address - Country:US
Practice Address - Phone:971-227-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst