Provider Demographics
NPI:1427172568
Name:TORRES, KENNIA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KENNIA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:KENNIA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:PO BOX 4245
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92605-4245
Mailing Address - Country:US
Mailing Address - Phone:310-000-0000
Mailing Address - Fax:
Practice Address - Street 1:17011 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5946
Practice Address - Country:US
Practice Address - Phone:714-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126021106H00000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner