Provider Demographics
NPI:1578232732
Name:DEL TORO, VIRGINIA (PPS)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:DEL TORO
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7489 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:CA
Mailing Address - Zip Code:95388-9460
Mailing Address - Country:US
Mailing Address - Phone:209-631-6685
Mailing Address - Fax:
Practice Address - Street 1:1401 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-3546
Practice Address - Country:US
Practice Address - Phone:209-631-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool