Provider Demographics
NPI:1891297636
Name:TORRES, JUAN ALEJANDRO
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:ALEJANDRO
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11541 WOODSIDE TER
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4730
Mailing Address - Country:US
Mailing Address - Phone:619-733-3810
Mailing Address - Fax:
Practice Address - Street 1:15373 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-3415
Practice Address - Country:US
Practice Address - Phone:858-699-7579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst