Healthcare Provider Details

I. General information

NPI: 1871423251
Provider Name (Legal Business Name): ITZEL MAILEE TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W TOWN AND COUNTRY RD STE 1250
ORANGE CA
92868-4633
US

IV. Provider business mailing address

PO BOX 10054
FULLERTON CA
92838-6054
US

V. Phone/Fax

Practice location:
  • Phone: 714-882-1409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number103K00000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: