Healthcare Provider Details

I. General information

NPI: 1386864445
Provider Name (Legal Business Name): HEIDI H IRWIN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI JEANNE HUNTON

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9415 CAMPUS POINT DRIVE
LA JOLLA CA
92093
US

IV. Provider business mailing address

10602 HUNTERS GLEN DR
SAN DIEGO CA
92130-4849
US

V. Phone/Fax

Practice location:
  • Phone: 858-822-3416
  • Fax: 858-822-1849
Mailing address:
  • Phone: 858-755-7484
  • Fax: 858-755-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8404
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN493755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: