MEDICARE: MRS. ELIZABETH URBANO MSW; LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	ASW17070	CA
2	1041C0700X	Clinical Social Worker	LCSW27687	CA

General Provider Information

NPI Number	:	1821141466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH URBANO MSW; LCSW

Provider Business Mailing Address
First Line	:	3097 WILLOW AVE STE 9
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93612-4715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3097 WILLOW AVE STE 9
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93612-4715
Country	:	US
Telephone Number	:	559-313-4603
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	03/17/2018

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