Provider Demographics
NPI:1437210762
Name:IRWIN, NANCY B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:B
Last Name:IRWIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S. BARRINGTON AVENUE
Mailing Address - Street 2:#308
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-235-2882
Mailing Address - Fax:310-235-2884
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:#308
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-235-2882
Practice Address - Fax:310-235-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB31394103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical