Provider Demographics
NPI:1902945959
Name:COVARRUBIAS, IRENE (LCSW, PPSC)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:COVARRUBIAS
Suffix:
Gender:
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 E JACK LONDON BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-1855
Mailing Address - Country:US
Mailing Address - Phone:925-606-3200
Mailing Address - Fax:
Practice Address - Street 1:685 E JACK LONDON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-1855
Practice Address - Country:US
Practice Address - Phone:925-606-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 22313101YM0800X
CA704151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health