Healthcare Provider Details

I. General information

NPI: 1346119880
Provider Name (Legal Business Name): SARINA R DE LA TORRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E ROUTE 66 STE 115
GLENDORA CA
91740-6360
US

IV. Provider business mailing address

885 N ELEANOR ST UNIT 2
POMONA CA
91767-4715
US

V. Phone/Fax

Practice location:
  • Phone: 909-631-6012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number101021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: