Individual
IRENE MAYORGADIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHIATRIC TECH
Contact information
Practice address
2656 MUSCATEL AVE, ROSEMEAD, CA 91770
(760) 373-0634
Mailing address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 407-4196
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
PT41284
CA
167G00000X
Licensed Psychiatric Technician
Primary
41284
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT41284
PSYCHIATRIC TECHNICIAN
CA
Enumeration date
12/03/2020
Last updated
07/23/2024
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