Provider Demographics
NPI:1699381608
Name:URBINA, STEPHANIE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:URBINA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12530 10TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3520
Mailing Address - Country:US
Mailing Address - Phone:909-248-3434
Mailing Address - Fax:
Practice Address - Street 1:12530 10TH ST STE C
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3520
Practice Address - Country:US
Practice Address - Phone:909-248-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW100326101YM0800X, 1041C0700X
CALCSW1281181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1041C0700XOtherCHILDRENS BUREAU