Provider Demographics
NPI:1609027424
Name:TORRES, REBEKAH GRACE (NP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:GRACE
Last Name:TORRES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:GRACE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 JOURNEY STE 210
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5332
Mailing Address - Country:US
Mailing Address - Phone:949-305-7122
Mailing Address - Fax:949-305-7160
Practice Address - Street 1:5 JOURNEY
Practice Address - Street 2:SUITE 210
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5336
Practice Address - Country:US
Practice Address - Phone:949-305-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA601628163W00000X
CA17849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse