Provider Demographics
NPI:1447068135
Name:AUSTRIA, IRENE AMPARO (NP)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:AMPARO
Last Name:AUSTRIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 GLORIOSA AVE
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-7822
Mailing Address - Country:US
Mailing Address - Phone:213-610-5030
Mailing Address - Fax:
Practice Address - Street 1:611 GLORIOSA AVE
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-7822
Practice Address - Country:US
Practice Address - Phone:213-610-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily