Provider Demographics
NPI:1467153304
Name:TORRES, LIDIA
Entity Type:Individual
Prefix:MRS
First Name:LIDIA
Middle Name:
Last Name:TORRES
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 1:931 W. HOLT BLVD.
Mailing Address - Street 2:SUITE #14
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3676
Mailing Address - Country:US
Mailing Address - Phone:909-675-6963
Mailing Address - Fax:
Practice Address - Street 1:679 N. BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-4703
Practice Address - Country:US
Practice Address - Phone:909-601-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker