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AMY NICOLE URBAN
NPI 1144508094
Marriage & Family Therapist in San Rafael, CA

Active since July 26, 2011Opted out of Medicare · through Apr 19, 2028
111 SMITH RANCH RD, SAN RAFAEL, CA 94903(415) 491-3000 Get Directions Write a Review

NPPES record last updated: July 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amy Nicole Urban NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY NICOLE URBAN (NPI 1144508094) is an individual marriage & family therapist in San Rafael, California and active in the NPI registry since July 2011. She has opted out of Medicare through April 19, 2028 and maintains a secondary practice location in Santa Rosa.

NPPES Registry Identity

NPI1144508094
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameAMY NICOLE URBAN
Location Address111 SMITH RANCH RDSan Rafael, CA 94903
Mailing Address111 Smith Ranch RdSan Rafael, CA 94903-1939
Phone(415) 491-3000
Sole ProprietorYes
Enumeration DateJuly 26, 2011
Last NPPES UpdateJuly 25, 2019
✔ NPI 1144508094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
111 SMITH RANCH RD, San Rafael, CA 94903
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Secondary Practice Location 1

Location 1751 Lombardi Ct, Suite CSanta Rosa, CA 95407-6798 · Phone (707) 545-4551 ext. 256

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Amy Nicole Urban has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 19, 2024 through April 19, 2028.

Opt-Out Effective DateApril 19, 2024
Opt-Out In Effect ThroughApril 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE LOPEZ
Psychologist
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3127
ASFAND KHAN
Psychiatry & Neurology (Psychiatry)
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3000
JENNIFER DAWN ROSSI MA
Marriage & Family Therapist
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3000
DR. KIM HUONG HUYNH PH.D.
Psychologist (Clinical)
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3011
CORINNE HEIMER
Psychologist
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3000
JONATHAN MICHAEL DUBOS
Psychologist (Clinical Child & Adolescent)
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3000
SHIRI LICHTENSTEIN PSYD
Psychologist
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3000
DR. MONA COLLADO FERRER-KAW M.D.
Psychiatry & Neurology (Addiction Medicine)
111 SMITH RANCH RD
SAN RAFAEL, CA 94903
Marin County (415) 491-3205

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Urban's NPI number?

The NPI number for Amy Urban is 1144508094. It was assigned to this individual provider in the NPPES registry on July 26, 2011.

Where is Amy Urban located?

Amy Urban practices at 111 Smith Ranch Rd, San Rafael, CA 94903. The listed phone number is (415) 491-3000.

What is Amy Urban's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Amy Urban enrolled in Medicare?

No. Amy Urban has opted out of Medicare through April 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Amy Urban was last updated on July 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.