Provider Demographics
NPI:1447048046
Name:LATORRE, PHYLICIA CHRISTINE ACLAN
Entity type:Individual
Prefix:
First Name:PHYLICIA CHRISTINE
Middle Name:ACLAN
Last Name:LATORRE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 ENCINAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4412
Mailing Address - Country:US
Mailing Address - Phone:510-337-7006
Mailing Address - Fax:
Practice Address - Street 1:2201 ENCINAL AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4412
Practice Address - Country:US
Practice Address - Phone:510-337-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator