Basic Information
| Provider Information | |||||||||
| NPI: | 1881768182 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 852 ELM AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908134415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143239327 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 N BROOKHURST ST | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928015226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144907711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.