Provider Demographics
NPI:1295964161
Name:TORRES, ANN D
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:D
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 1:9684 BALSA ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-2213
Mailing Address - Country:US
Mailing Address - Phone:909-989-1058
Mailing Address - Fax:909-484-1011
Practice Address - Street 1:9684 BALSA ST
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-2213
Practice Address - Country:US
Practice Address - Phone:909-989-1058
Practice Address - Fax:909-484-1011
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366401693311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home