MEDICARE: DR. IRENE L LOEWEN PH.D.

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
1	103T00000X	Psychologist	PSY9555	CA

General Provider Information

NPI Number	:	1942478813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRENE L LOEWEN PH.D.

Provider Business Mailing Address
First Line	:	200 E DEL MAR BLVD STE 126
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2551
Country	:	US
Telephone Number	:	626-449-2525
Fax Number	:	626-564-1250

Provider Business Practice Location Address
First Line	:	200 E DEL MAR BLVD STE 126
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2551
Country	:	US
Telephone Number	:	626-449-2525
Fax Number	:	626-564-1250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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