Provider Demographics
NPI:1588785299
Name:TORRES, JOE RIVAS I (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:RIVAS
Last Name:TORRES
Suffix:I
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:28137 AVENUE 14
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638
Mailing Address - Country:US
Mailing Address - Phone:559-673-3508
Mailing Address - Fax:559-661-2818
Practice Address - Street 1:14277 ROAD 28
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-5715
Practice Address - Country:US
Practice Address - Phone:559-673-3508
Practice Address - Fax:559-661-2818
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCS111871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02270ZMedicaid