Healthcare Provider Details

I. General information

NPI: 1285068031
Provider Name (Legal Business Name): ERICA MARIE URENO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE FL 6
LONG BEACH CA
90806-2325
US

IV. Provider business mailing address

2600 REDONDO AVE FL 6
LONG BEACH CA
90806-2325
US

V. Phone/Fax

Practice location:
  • Phone: 562-256-7920
  • Fax:
Mailing address:
  • Phone: 562-256-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: