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General NPI Number Information
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NPI Number | 1407388457
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Entity Type | Individual
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Provider Name | MARIA CECILIA IRIGARAY
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 5555 RESERVOIR DR STE 309
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City | SAN DIEGO
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State | CA
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Zip | 92120-5193
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Country | US
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Telephone | 619-393-5333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22292
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City | SAN DIEGO
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State | CA
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Zip | 92192-2292
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 139402
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License Number State | CA
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