Provider Demographics
NPI:1780706424
Name:DE LA TORRE-PENA, ALVA ILEANA (MS MFT I)
Entity type:Individual
Prefix:MS
First Name:ALVA
Middle Name:ILEANA
Last Name:DE LA TORRE-PENA
Suffix:
Gender:F
Credentials:MS MFT I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 DIXON ST
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2149
Mailing Address - Country:US
Mailing Address - Phone:530-345-1600
Mailing Address - Fax:530-345-1685
Practice Address - Street 1:865 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965
Practice Address - Country:US
Practice Address - Phone:530-538-7956
Practice Address - Fax:530-538-7949
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist