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General NPI Number Information
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NPI Number | 1508655309
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Entity Type | Individual
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Provider Name | RENEE UBA
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Gender |
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3680 E IMPERIAL HWY STE 220-240
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City | LYNWOOD
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State | CA
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Zip | 90262-2659
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Country | US
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Telephone | 323-769-7174
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Fax |
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Provider Business Mailing Address
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Address Line | 3680 E IMPERIAL HWY STE 220-240X
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City | LYNWOOD
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State | CA
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Zip | 90262-2659
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Country | US
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Telephone |
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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