Provider Demographics
NPI:1851893960
Name:TORRES, MARITZA (MS)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2926
Mailing Address - Street 2:
Mailing Address - City:BLUE JAY
Mailing Address - State:CA
Mailing Address - Zip Code:92317-2926
Mailing Address - Country:US
Mailing Address - Phone:657-262-2001
Mailing Address - Fax:
Practice Address - Street 1:17982 SKY PARK CIR STE J
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6482
Practice Address - Country:US
Practice Address - Phone:949-809-5700
Practice Address - Fax:949-809-5779
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB-94023113101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health