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General NPI Number Information
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NPI Number | 1508695396
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Entity Type | Organization
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Legal Business Name | IRIS PSYCHOLOGICAL & WELLNESS SERVICES
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 4000 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1713
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Country | US
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Telephone | 949-371-6135
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Fax | 949-449-8572
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Provider Business Mailing Address
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Address Line | 4000 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1713
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Country | US
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Telephone | 949-371-6135
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Fax | 949-449-8572
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. HUMBERTO R HERNANDEZ
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Credential | PH.D.
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Telephone | 562-281-7595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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