Healthcare Provider Details

I. General information

NPI: 1114553419
Provider Name (Legal Business Name): IRENE OROZCO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 TELEGRAPH AVE STE 100
BERKELEY CA
94705-2031
US

IV. Provider business mailing address

3530 WILSHIRE BLVD STE 1180
LOS ANGELES CA
90010-2361
US

V. Phone/Fax

Practice location:
  • Phone: 510-686-3621
  • Fax:
Mailing address:
  • Phone: 323-419-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95010181
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: