Provider Demographics
NPI:1982260345
Name:TORRES, KAYLA NICOLE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:NICOLE
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 1:937 N PEACH AVE # B115
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-2485
Mailing Address - Country:US
Mailing Address - Phone:559-470-2802
Mailing Address - Fax:
Practice Address - Street 1:937 N PEACH AVE # B115
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-2485
Practice Address - Country:US
Practice Address - Phone:559-470-2802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN685787164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVN685787OtherBVNPT