MEDICARE: HEIDI IRWIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95418717	CA
2	363LA2100X	Acute Care Nurse Practitioner	95036430	CA

General Provider Information

NPI Number	:	1801272596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI IRWIN

Provider Business Mailing Address
First Line	:	4859 ALMIDOR AVE
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-3708
Country	:	US
Telephone Number	:	480-848-7427
Fax Number	:

Provider Business Practice Location Address
First Line	:	4859 ALMIDOR AVE
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-3708
Country	:	US
Telephone Number	:	480-848-7427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	01/09/2026

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Directions to “ HEIDI IRWIN ” Practice Location

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