Provider Demographics
NPI:1053827188
Name:TORRES, THERESA (MFTI)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:NA
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THERESATORRES
Mailing Address - Street 1:3801 DUCKHORN DR APT 836
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1083
Mailing Address - Country:US
Mailing Address - Phone:916-410-4083
Mailing Address - Fax:
Practice Address - Street 1:3050 BEACON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3467
Practice Address - Country:US
Practice Address - Phone:916-462-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102032106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist