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General NPI Number Information
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NPI Number | 1073956348
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Entity Type | Individual
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Provider Name | LUIS ROBERT UCEDA M.A. LPC
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Gender | Male
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2801 MAIN ST
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City | IRVINE
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State | CA
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Zip | 92614-5027
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Country | US
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Telephone | 949-299-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 MAIN ST APT 356
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City | IRVINE
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State | CA
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Zip | 92614-5016
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Country | US
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Telephone | 949-299-7385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0016782
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0000293
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License Number State | CO
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