Provider Demographics
NPI:1699395988
Name:IRMITER, ADELE
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:
Last Name:IRMITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W VINEYARD AVE APT 380
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2072
Mailing Address - Country:US
Mailing Address - Phone:805-843-1619
Mailing Address - Fax:
Practice Address - Street 1:301 W VINEYARD AVE APT 380
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2072
Practice Address - Country:US
Practice Address - Phone:805-843-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician