Provider Demographics
NPI:1225380819
Name:TORRES, PATRICIA (OC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:OC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PORTER DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1587
Mailing Address - Country:US
Mailing Address - Phone:925-362-2147
Mailing Address - Fax:
Practice Address - Street 1:4000 DUBLIN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3113
Practice Address - Country:US
Practice Address - Phone:925-556-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7950225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT7950OtherMEDICAL LICENSE NUMBER