1790593192 NPI number — MRS. VANESSA TORRES M.S.

Table of content: MRS. VANESSA TORRES M.S. (NPI 1790593192)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790593192 NPI number — MRS. VANESSA TORRES M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES
Provider First Name:
VANESSA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOMEZ
Provider Other First Name:
VANESSA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790593192
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23371 MULHOLLAND DR UNIT 429
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91364-2734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-531-6999
Provider Business Mailing Address Fax Number:
626-531-6998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
440 E HUNTINGTON DR STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91006-3775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-531-6999
Provider Business Practice Location Address Fax Number:
626-531-6998
Provider Enumeration Date:
12/18/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X , with the licence number:  453252953 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)