Provider Demographics
NPI:1982571642
Name:TORREY, MICHAEL FONTAINE (RN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FONTAINE
Last Name:TORREY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34189 GANNON TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1944
Mailing Address - Country:US
Mailing Address - Phone:510-402-3162
Mailing Address - Fax:
Practice Address - Street 1:2410 SAMARITAN DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3909
Practice Address - Country:US
Practice Address - Phone:408-369-9798
Practice Address - Fax:408-369-9895
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303248163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse