Provider Demographics
NPI:1518197201
Name:TORRES, ANDREA DENISE (MFTI)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:DENISE
Last Name:TORRES
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:DENISE
Other - Last Name:CORREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 CHADBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-9613
Mailing Address - Country:US
Mailing Address - Phone:707-422-0464
Mailing Address - Fax:707-422-0465
Practice Address - Street 1:490 CHADBOURNE RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9613
Practice Address - Country:US
Practice Address - Phone:707-422-0464
Practice Address - Fax:707-422-0465
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01AVOtherMEDICAL