Individual
MAXINE ANN IRVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40925 COUNTY CENTER DR, TEMECULA, CA 92591-6054
(951) 600-6420
(951) 600-6419
Mailing address
40925 COUNTY CENTER DR, TEMECULA, CA 92591-6054
(951) 600-6420
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
CAFPET012618-7
CA
175T00000X
Peer Specialist
Primary
MPSS-EMSKDG
CA
Other
Enumeration date
06/16/2022
Last updated
03/01/2023
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