Individual
LISA MARIE IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 IMPERIAL HWY, FULLERTON, CA 92835-1145
(714) 447-7000
(714) 447-7003
Mailing address
401 IMPERIAL HWY, FULLERTON, CA 92835-1145
(714) 447-7000
(714) 447-7003
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033578299
NON-BILLABLE
CA
Enumeration date
02/16/2016
Last updated
06/17/2025
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