Provider Demographics
NPI:1396284980
Name:VAZQUEZ-UREN, INGRID PAMELA
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:PAMELA
Last Name:VAZQUEZ-UREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N CUYAMACA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1865
Mailing Address - Country:US
Mailing Address - Phone:619-448-0420
Mailing Address - Fax:619-448-0131
Practice Address - Street 1:900 N CUYAMACA ST STE 110
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1865
Practice Address - Country:US
Practice Address - Phone:619-448-0420
Practice Address - Fax:619-448-0131
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA1083321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator