Individual
IRENE JANNETTE GODINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 EL CAMINO REAL STE 213, TUSTIN, CA 92780-3656
(714) 805-6510
Mailing address
1891 EFFIE ST, LOS ANGELES, CA 90026-1711
(323) 644-2000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
18337
CA
106S00000X
Behavior Technician
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/07/2020
Last updated
03/17/2025
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