Individual
IRENE NDIBAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
547 N HOMEREST AVE, WEST COVINA, CA 91791-1233
(626) 227-4698
Mailing address
547 N HOMEREST AVE, WEST COVINA, CA 91791-1233
(626) 227-4698
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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