Healthcare Provider Details

I. General information

NPI: 1558122101
Provider Name (Legal Business Name): ESPERANZA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 N MASTICK WAY
NOGALES AZ
85621-1063
US

IV. Provider business mailing address

825 N GRAND AVE STE 100
NOGALES AZ
85621
US

V. Phone/Fax

Practice location:
  • Phone: 520-375-5000
  • Fax: 520-287-4747
Mailing address:
  • Phone: 520-761-2128
  • Fax: 520-281-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLAC23434
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: