Basic Information
Provider Information
NPI: 1720265614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORRES
FirstName: HECTOR
MiddleName: MANUEL
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 150 VALPREDA ROAD
Address2:  
City: SAN MARCOS
State: CA
PostalCode: 92069
CountryCode: US
TelephoneNumber: 7607366767
FaxNumber: 7607368740
Practice Location
Address1: 150 VALPREDA RD
Address2:  
City: SAN MARCOS
State: CA
PostalCode: 920692973
CountryCode: US
TelephoneNumber: 7607366767
FaxNumber: 7607368740
Other Information
ProviderEnumerationDate: 01/23/2008
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY13309CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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