Provider Demographics
NPI:1063073583
Name:MINDING YOUR BODY
Entity type:Organization
Organization Name:MINDING YOUR BODY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-747-8006
Mailing Address - Street 1:2443 FILLMORE ST # 380-1019
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1814
Mailing Address - Country:US
Mailing Address - Phone:707-409-0852
Mailing Address - Fax:
Practice Address - Street 1:250 BEL MARIN KEYS BOULEVARD
Practice Address - Street 2:SUITE D1
Practice Address - City:NEVATO
Practice Address - State:CA
Practice Address - Zip Code:94949
Practice Address - Country:US
Practice Address - Phone:707-409-0852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)