Provider Demographics
NPI:1215171426
Name:TORRES, ANGELA NICOLE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:NICOLE
Last Name:TORRES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HERMITAGE RD
Mailing Address - Street 2:UNIT 2211
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-1338
Mailing Address - Country:US
Mailing Address - Phone:804-524-7087
Mailing Address - Fax:804-524-7567
Practice Address - Street 1:107 S 5TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3825
Practice Address - Country:US
Practice Address - Phone:804-819-4000
Practice Address - Fax:804-819-5221
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004018103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical