Provider Demographics
NPI:1710333117
Name:NAVARRETE, IRVIN
Entity Type:Individual
Prefix:
First Name:IRVIN
Middle Name:
Last Name:NAVARRETE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31524 LOS RIOS ST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2520
Mailing Address - Country:US
Mailing Address - Phone:949-973-4779
Mailing Address - Fax:
Practice Address - Street 1:4299 MACARTHUR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2095
Practice Address - Country:US
Practice Address - Phone:949-480-7767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist