Healthcare Provider Details

I. General information

NPI: 1184516874
Provider Name (Legal Business Name): ALEXANDRE NICOLE URBEN ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 FRANKLIN AVE
RIVERSIDE CA
92507-3337
US

IV. Provider business mailing address

PO BOX 3404
RIVERSIDE CA
92519-3404
US

V. Phone/Fax

Practice location:
  • Phone: 800-499-3008
  • Fax:
Mailing address:
  • Phone: 727-742-2404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: