Provider Demographics
NPI:1295938330
Name:TORRES, VIVIAN R (LCSW)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:R
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 CRESTON RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2405
Mailing Address - Country:US
Mailing Address - Phone:925-930-8646
Mailing Address - Fax:
Practice Address - Street 1:91 GREGORY LN
Practice Address - Street 2:SUITE 19
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4981
Practice Address - Country:US
Practice Address - Phone:925-930-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical