Provider Demographics
NPI:1346571742
Name:DE LA TORRE, EUFEMIANO (LMFT)
Entity type:Individual
Prefix:MR
First Name:EUFEMIANO
Middle Name:
Last Name:DE LA TORRE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 CANYON DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2411
Mailing Address - Country:US
Mailing Address - Phone:323-686-5154
Mailing Address - Fax:
Practice Address - Street 1:439 N LARCHMONT BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3043
Practice Address - Country:US
Practice Address - Phone:323-686-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37332106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist