Provider Demographics
NPI:1033928957
Name:CARRETERO, IRENE PAZ (AMFT)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:PAZ
Last Name:CARRETERO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:PAZ
Other - Last Name:CARRETERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:1027 W ARLINGTON AVE APT D
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2148
Mailing Address - Country:US
Mailing Address - Phone:909-333-2664
Mailing Address - Fax:
Practice Address - Street 1:1027 W ARLINGTON AVE APT D
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2148
Practice Address - Country:US
Practice Address - Phone:909-333-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty