Healthcare Provider Details

I. General information

NPI: 1891972980
Provider Name (Legal Business Name): LILIANA TORRES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 09/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 SHATTUCK AVE STE. 210
BERKELEY CA
94704-2076
US

IV. Provider business mailing address

2008 N. GAREY AVE.
POMONA CA
91767
US

V. Phone/Fax

Practice location:
  • Phone: 510-704-7475
  • Fax: 510-704-7494
Mailing address:
  • Phone: 909-623-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: