Healthcare Provider Details

I. General information

NPI: 1932061587
Provider Name (Legal Business Name): IRMA PADILLA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 CENTER AVE STE 160
RANCHO CUCAMONGA CA
91730-5838
US

IV. Provider business mailing address

9600 CENTER AVE STE 160
RANCHO CUCAMONGA CA
91730-5838
US

V. Phone/Fax

Practice location:
  • Phone: 858-264-5858
  • Fax:
Mailing address:
  • Phone: 858-264-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: