Provider Demographics
NPI:1831757863
Name:DES ROCHES, TOR ERAN (MSW)
Entity type:Individual
Prefix:
First Name:TOR
Middle Name:ERAN
Last Name:DES ROCHES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 HOWARD WAY STE 150
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1496
Mailing Address - Country:US
Mailing Address - Phone:949-646-9227
Mailing Address - Fax:
Practice Address - Street 1:3540 HOWARD WAY STE 150
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1496
Practice Address - Country:US
Practice Address - Phone:949-646-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW118943104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker