Healthcare Provider Details

I. General information

NPI: 1417370008
Provider Name (Legal Business Name): IRIS MARIA PACHLER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7949 CALIFORNIA AVE SUITE 10
FAIR OAKS CA
95628-7156
US

IV. Provider business mailing address

7949 CALIFORNIA AVE SUITE 10
FAIR OAKS CA
95628-7156
US

V. Phone/Fax

Practice location:
  • Phone: 530-417-5824
  • Fax: 916-404-0457
Mailing address:
  • Phone: 530-417-5824
  • Fax: 916-404-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26304
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPSY26304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: