Healthcare Provider Details

I. General information

NPI: 1528770021
Provider Name (Legal Business Name): SORAYDA TORRES SUDRC13435
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 S MENTOR AVE
PASADENA CA
91106-2902
US

IV. Provider business mailing address

44 S MENTOR AVE
PASADENA CA
91106-2902
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-9127
  • Fax:
Mailing address:
  • Phone: 626-795-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: