Provider Demographics
NPI:1407630049
Name:TORRES, CRISTINA LETICIA (LVN)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:LETICIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:LETICIA
Other - Last Name:BARAJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:2350 S DORA ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-6860
Mailing Address - Country:US
Mailing Address - Phone:707-391-5326
Mailing Address - Fax:
Practice Address - Street 1:144 STONY POINT RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4122
Practice Address - Country:US
Practice Address - Phone:707-521-4545
Practice Address - Fax:707-526-1016
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA698186164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse