Provider Demographics
NPI:1932281698
Name:DE LA TORRE, ANA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E ANGELENO AVE
Mailing Address - Street 2:APT 303
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501
Mailing Address - Country:US
Mailing Address - Phone:213-305-3238
Mailing Address - Fax:
Practice Address - Street 1:1149 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2213
Practice Address - Country:US
Practice Address - Phone:213-485-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner