Provider Demographics
NPI:1407058167
Name:TORRENS, DESIRAE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DESIRAE
Middle Name:
Last Name:TORRENS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W JOAQUIN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3667
Mailing Address - Country:US
Mailing Address - Phone:510-878-9709
Mailing Address - Fax:510-225-2570
Practice Address - Street 1:303 W JOAQUIN AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577
Practice Address - Country:US
Practice Address - Phone:510-878-9709
Practice Address - Fax:510-225-2570
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53874106H00000X
CAIMP54894106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist