Healthcare Provider Details

I. General information

NPI: 1598551541
Provider Name (Legal Business Name): KIRSTIE URANGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 KUHN DR STE 200
CHULA VISTA CA
91914-3551
US

IV. Provider business mailing address

891 KUHN DR STE 200
CHULA VISTA CA
91914-3551
US

V. Phone/Fax

Practice location:
  • Phone: 714-552-6712
  • Fax:
Mailing address:
  • Phone: 714-552-6712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: