Provider Demographics
NPI:1154535839
Name:TORRES, JENNIFER BAIRD
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BAIRD
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 - 2118 S. CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90001
Mailing Address - Country:US
Mailing Address - Phone:213-493-4664
Mailing Address - Fax:213-493-4665
Practice Address - Street 1:2116 - 2118 S. CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001
Practice Address - Country:US
Practice Address - Phone:213-493-4664
Practice Address - Fax:818-506-5185
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)