Provider Demographics
NPI:1508695396
Name:IRIS PSYCHOLOGICAL & WELLNESS SERVICES
Entity type:Organization
Organization Name:IRIS PSYCHOLOGICAL & WELLNESS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-281-7595
Mailing Address - Street 1:4000 BARRANCA PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1713
Mailing Address - Country:US
Mailing Address - Phone:949-371-6135
Mailing Address - Fax:949-449-8572
Practice Address - Street 1:4000 BARRANCA PKWY STE 250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1713
Practice Address - Country:US
Practice Address - Phone:949-371-6135
Practice Address - Fax:949-449-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)