Provider Demographics
NPI:1033668835
Name:DE LA TORRE, ABRAHAM (ACSW)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:DE LA TORRE
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:ABRAHAM
Other - Middle Name:
Other - Last Name:DE LA TORRE HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:330 E LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5617
Mailing Address - Country:US
Mailing Address - Phone:626-254-1400
Mailing Address - Fax:
Practice Address - Street 1:330 E LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5617
Practice Address - Country:US
Practice Address - Phone:626-254-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW132588104100000X
CA171M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program