Healthcare Provider Details

I. General information

NPI: 1518848258
Provider Name (Legal Business Name): ABEL URENA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WABASH AVE
SAN JOSE CA
95128-1931
US

IV. Provider business mailing address

PO BOX 394
ALVISO CA
95002-0394
US

V. Phone/Fax

Practice location:
  • Phone: 669-677-0326
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: