Healthcare Provider Details

I. General information

NPI: 1205769478
Provider Name (Legal Business Name): IRINA HAUVRE M.S., SLP-CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S MCCLELLAND ST
SANTA MARIA CA
93454-5120
US

IV. Provider business mailing address

4238 WOODMERE RD
SANTA MARIA CA
93455-3862
US

V. Phone/Fax

Practice location:
  • Phone: 805-720-1969
  • Fax:
Mailing address:
  • Phone: 805-720-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number24778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: