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NPI Code Detail

MEDICARE: JENNA JEAN TORRES PSYD, LP

MEDICARE: JENNA JEAN TORRES PSYD, LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist29138CA

General Provider Information

NPI Number : 1639439342
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA JEAN TORRES PSYD, LP
Provider Business Mailing Address
First Line : 1640 NEWPORT BLVD STE 110
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-7762
Country : US
Telephone Number : 925-282-1778
Fax Number :
Provider Business Practice Location Address
First Line : 1640 NEWPORT BLVD STE 110
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-7762
Country : US
Telephone Number : 925-282-1778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2012
Last Update Date : 10/22/2025

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