Provider Demographics
NPI:1669261301
Name:ONA, IRENE MAE (LCSW)
Entity type:Individual
Prefix:
First Name:IRENE MAE
Middle Name:
Last Name:ONA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 DEL MONTE AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3228
Mailing Address - Country:US
Mailing Address - Phone:847-858-0396
Mailing Address - Fax:
Practice Address - Street 1:4851 DEL MONTE AVE APT 6
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-3228
Practice Address - Country:US
Practice Address - Phone:847-858-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14008947-35011041C0700X
CA1215611041C0700X
IL1490181411041C0700X
AZ226041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical