Provider Demographics
NPI:1750862371
Name:TORRES, JARED (DPT, PT)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6745 VANPORT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-1629
Mailing Address - Country:US
Mailing Address - Phone:562-695-4396
Mailing Address - Fax:
Practice Address - Street 1:7941 BEACH BLVD STE J
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-1900
Practice Address - Country:US
Practice Address - Phone:714-736-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist