Provider Demographics
NPI:1083983829
Name:IRISH, RACHEL M (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:M
Last Name:IRISH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3897 DAWES ST UNIT 217
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3586
Mailing Address - Country:US
Mailing Address - Phone:951-529-2772
Mailing Address - Fax:
Practice Address - Street 1:1400 QUAIL ST STE 275
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2762
Practice Address - Country:US
Practice Address - Phone:951-529-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31712103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist