Provider Demographics
NPI:1023842804
Name:SAM URENA PSYCHOTHERAPY INC.
Entity type:Organization
Organization Name:SAM URENA PSYCHOTHERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:URENA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:818-430-7502
Mailing Address - Street 1:2304 ESKIMO LN
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-1462
Mailing Address - Country:US
Mailing Address - Phone:818-430-7502
Mailing Address - Fax:
Practice Address - Street 1:5266 HOLLISTER AVE STE 238
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2037
Practice Address - Country:US
Practice Address - Phone:805-620-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty