Nicole Irby, SUBSTANCE ABUSE

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1416050121 Issued in CA

Practice address

225 Grandview St
Pasadena, CA 91104-2114

Phone

(626) 676-3690

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1801473228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 GRANDVIEW ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042114",
            "telephone_number": "626-676-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 GRANDVIEW ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042114",
            "telephone_number": "626-676-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRBY",
        "first_name": "NICOLE",
        "credential": "SUBSTANCE ABUSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1416050121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "R1416050121",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Pasadena",
            "affiliation": "N",
            "endpointDescription": "SAPC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1230 N Marengo Ave",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911032217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cindy Inthavong
• Geonee Inyang
• Michael Shun Nun Ip, MD
• Muhammad Raghib Iqbal, M.D.
• Marukh Jehangir Irani, RPT
• Daniel Ireland
• Cynthia Iriarte
• Irina Jasper MD a Professional Corp
• Memi Lorico Iriye, MS
• Emma Irvin, LCSW

• Addiction (Substance Use Disorder) Counselor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.