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NPI Code Detail

MEDICARE: DR. RACHEL M IRISH PHD

MEDICARE:  DR. RACHEL M IRISH  PHD
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
1103T00000XPsychologist31712CA

General Provider Information

NPI Number : 1083983829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL M IRISH PHD
Provider Business Mailing Address
First Line : 3897 DAWES ST UNIT 217
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3586
Country : US
Telephone Number : 951-529-2772
Fax Number :
Provider Business Practice Location Address
First Line : 1400 QUAIL ST STE 275
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2762
Country : US
Telephone Number : 951-529-2772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2011
Last Update Date : 05/22/2020

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Directions to “ DR. RACHEL M IRISH PHD” Practice Location

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