Provider Demographics
NPI:1417326331
Name:TORTEN, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TORTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 VIA CERRITOS
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6821
Mailing Address - Country:US
Mailing Address - Phone:805-490-2901
Mailing Address - Fax:
Practice Address - Street 1:4218 VIA CERRITOS
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6821
Practice Address - Country:US
Practice Address - Phone:805-490-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 8670174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist