Healthcare Provider Details

I. General information

NPI: 1073069183
Provider Name (Legal Business Name): ERIN MICHELLE VIRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 E DEL MAR BLVD
PASADENA CA
91107-4321
US

IV. Provider business mailing address

2810 E DEL MAR BLVD
PASADENA CA
91107-4321
US

V. Phone/Fax

Practice location:
  • Phone: 562-666-9055
  • Fax:
Mailing address:
  • Phone: 562-666-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number86021
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101102
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: