Individual
IRINA CARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2101 FOREST AVE STE 220A, SAN JOSE, CA 95128-1473
(408) 295-8628
Mailing address
1150 MAIN ST STE 3, WATSONVILLE, CA 95076-3760
(815) 289-0039
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95008283
CA
363LF0000X
Family Nurse Practitioner
95008283
CA
Other
Enumeration date
02/07/2018
Last updated
01/03/2022
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