Provider Demographics
NPI:1386473296
Name:MCCOY, EILEEN M (NBC-HWC)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:MCCOY
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 SONOMA AISLE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3936
Mailing Address - Country:US
Mailing Address - Phone:949-229-0018
Mailing Address - Fax:
Practice Address - Street 1:607 SONOMA AISLE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3936
Practice Address - Country:US
Practice Address - Phone:949-229-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-3888045171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach