Provider Demographics
NPI:1942459268
Name:TORRES, MONIQUE MARIE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MARIE
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PORTICO LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-1138
Mailing Address - Country:US
Mailing Address - Phone:209-815-6759
Mailing Address - Fax:
Practice Address - Street 1:4527 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2603
Practice Address - Country:US
Practice Address - Phone:415-337-4800
Practice Address - Fax:415-333-2058
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program