Individual
IRINA KOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
(818) 896-1161
(818) 896-5069
Mailing address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
(818) 896-1161
(818) 896-5069
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94025992
CA
225C00000X
Rehabilitation Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6758
—
CA
05
—
7068
—
CA
05
—
7420
—
CA
Enumeration date
06/20/2013
Last updated
11/16/2021
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