| Doctor Name: | TIMOTHY IRVING |
| NPI Number: | 1083039432 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 11205160941 |
| Business Practice Address: | 40925 County Center Dr Temecula, CA - 925916054 |
| Business Phone Number: | 9516006360 |
| Business Fax Number: | 9516006365 |
| Mailing Address: | 40925 County Center Dr, TEMECULA |
| State: | CA |
| Postal Code: | 925916054 |
| Phone Number: | 9516006363 |
| Fax Number: | 9516006365 |
| NPI Enumeration Date: | 02/21/2014 |
| NPI Last Update Date: | 10/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 11205160941 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |