MEDICARE: VICTOR URREGO-VALLOWE 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	LCSW87398	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912391632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR URREGO-VALLOWE LCSW

Provider Business Mailing Address
First Line	:	3808 AUBURN BLVD STE 46
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2122
Country	:	US
Telephone Number	:	916-256-7107
Fax Number	:	916-251-1148

Provider Business Practice Location Address
First Line	:	3808 AUBURN BLVD STE 46
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2122
Country	:	US
Telephone Number	:	916-256-7107
Fax Number	:	916-251-1148

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

Provider Enumeration Date	:	03/19/2015
Last Update Date	:	04/07/2023

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