Provider Demographics
NPI:1972877918
Name:TORRES, ANDRES
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13225 KELOWNA ST
Mailing Address - Street 2:E104
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-4001
Mailing Address - Country:US
Mailing Address - Phone:818-895-5002
Mailing Address - Fax:818-895-5502
Practice Address - Street 1:13225 KELOWNA ST
Practice Address - Street 2:E104
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-4001
Practice Address - Country:US
Practice Address - Phone:818-895-5002
Practice Address - Fax:818-895-5502
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)