Provider Demographics
NPI:1326758194
Name:CARTER TORRES, WILLIAM LAMAR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LAMAR
Last Name:CARTER 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 1:330 MOSS ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2005
Mailing Address - Country:US
Mailing Address - Phone:619-585-4228
Mailing Address - Fax:619-585-4625
Practice Address - Street 1:330 MOSS ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2005
Practice Address - Country:US
Practice Address - Phone:619-585-4228
Practice Address - Fax:619-585-4625
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral