Provider Demographics
NPI:1609082361
Name:RANAHAN, IRINA C (MS)
Entity Type:Individual
Prefix:MS
First Name:IRINA
Middle Name:C
Last Name:RANAHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3339
Mailing Address - Country:US
Mailing Address - Phone:650-872-0881
Mailing Address - Fax:
Practice Address - Street 1:1357 PARK AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3339
Practice Address - Country:US
Practice Address - Phone:650-872-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health