Koll, Irina

Koll, Irina is an individual health care provider with primary practice located at 12450 Van Nuys Blvd Ste 200 , Pacoima CA 91331-1393. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Koll, Irina can be contacted via phone (818) 896-1161.

Contact Information

Primary practice address
12450 Van Nuys Blvd Ste 200 Pacoima CA 91331-1393
Phone: (818) 896-1161
Fax: (818) 896-5069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSB94025992 California

Profile Details

NPI number 1770922916
LBN Legal business name Koll, Irina
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2013
Last updated Nov 16th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770922916 NPPES
California MEDICAID 6758
California MEDICAID 7420
California MEDICAID 7068

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