Provider Demographics
NPI:1992591408
Name:TORRO, JESSICA DORESTANT (RDN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DORESTANT
Last Name:TORRO
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 MACKENZIE CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-8930
Mailing Address - Country:US
Mailing Address - Phone:954-990-3008
Mailing Address - Fax:
Practice Address - Street 1:1600 MACKENZIE CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-8930
Practice Address - Country:US
Practice Address - Phone:954-990-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86073520133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered