Eugene Sanborn Urbain, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 15652 Issued in CA

Practice address

851 Fremont Ave
Suite 210
Los Altos, CA 94024-5698

Phone

(650) 544-3935

Fax

(650) 594-1632

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215051735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2564 SAN CARLOS AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940701746",
            "telephone_number": "650-544-3935",
            "fax_number": "650-594-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 FREMONT AVE",
            "address_2": "SUITE 210",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245698",
            "telephone_number": "650-544-3935",
            "fax_number": "650-594-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAIN",
        "first_name": "EUGENE",
        "middle_name": "SANBORN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 15652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Los Altos, CA
• Providers in Los Altos, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.