Provider Demographics
NPI:1902945959
Name:COVARRUBIAS, IRENE (ASW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:COVARRUBIAS
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22211 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2712
Mailing Address - Country:US
Mailing Address - Phone:510-471-5880
Mailing Address - Fax:510-690-9065
Practice Address - Street 1:22211 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2712
Practice Address - Country:US
Practice Address - Phone:510-471-5880
Practice Address - Fax:510-690-9065
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 22313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health