Provider Demographics
NPI:1790593192
Name:TORRES, VANESSA (MS)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:23371 MULHOLLAND DR UNIT 429
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2734
Mailing Address - Country:US
Mailing Address - Phone:626-531-6999
Mailing Address - Fax:626-531-6998
Practice Address - Street 1:440 E HUNTINGTON DR STE 300
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3775
Practice Address - Country:US
Practice Address - Phone:626-531-6999
Practice Address - Fax:626-531-6998
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453252953106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician