Provider Demographics
NPI:1730547720
Name:BROWN, IRENE S (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4195 CHINO HILLS PKWY # 1106
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2618
Mailing Address - Country:US
Mailing Address - Phone:909-342-2219
Mailing Address - Fax:
Practice Address - Street 1:4195 CHINO HILLS PKWY # 1106
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2618
Practice Address - Country:US
Practice Address - Phone:909-342-2219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist