Provider Demographics
NPI:1346740792
Name:DE LA TORRE, KAREN (MA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3917
Mailing Address - Country:US
Mailing Address - Phone:415-229-0500
Mailing Address - Fax:415-647-0740
Practice Address - Street 1:2919 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3917
Practice Address - Country:US
Practice Address - Phone:415-229-0500
Practice Address - Fax:415-647-3662
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171M00000X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KDELATORREOtherMENTAL HEALTH