Provider Demographics
NPI:1255858486
Name:TORRES, KARINNA (MSW)
Entity Type:Individual
Prefix:
First Name:KARINNA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 BAUCHET ST STE 204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2544
Mailing Address - Country:US
Mailing Address - Phone:323-548-6928
Mailing Address - Fax:
Practice Address - Street 1:429 BAUCHET ST STE 204
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2544
Practice Address - Country:US
Practice Address - Phone:323-548-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2021-02-02
Deactivation Date:2018-05-18
Deactivation Code:
Reactivation Date:2018-06-20
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
171M00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker