Provider Demographics
NPI:1124391362
Name:VECCHIO, IRENE (MA, MFT)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:VECCHIO
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230357
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-0357
Mailing Address - Country:US
Mailing Address - Phone:760-492-5858
Mailing Address - Fax:
Practice Address - Street 1:638 RANCHO SANTA FE RD
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6542
Practice Address - Country:US
Practice Address - Phone:760-492-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist