Provider Demographics
NPI:1922693704
Name:TORRES, VICTORIA PATRICIA (RD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PATRICIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2057 WILLESTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2013
Mailing Address - Country:US
Mailing Address - Phone:408-480-0501
Mailing Address - Fax:
Practice Address - Street 1:2057 WILLESTER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2013
Practice Address - Country:US
Practice Address - Phone:408-480-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86092422133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered