Provider Demographics
NPI:1629157938
Name:GINSBURG, IRENA F (PHD)
Entity Type:Individual
Prefix:
First Name:IRENA
Middle Name:F
Last Name:GINSBURG
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 1:38 QUAIL CT STE 100
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8726
Mailing Address - Country:US
Mailing Address - Phone:925-984-5666
Mailing Address - Fax:925-266-3293
Practice Address - Street 1:38 QUAIL CT STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8726
Practice Address - Country:US
Practice Address - Phone:925-984-5666
Practice Address - Fax:925-266-3293
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19337103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL193370Medicare ID - Type Unspecified