Healthcare Provider Details

I. General information

NPI: 1528514569
Provider Name (Legal Business Name): LISA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 MARKET ST
REDDING CA
96001-1023
US

IV. Provider business mailing address

2280 BENTON DR BLDG C, STE B
REDDING CA
96003-5349
US

V. Phone/Fax

Practice location:
  • Phone: 530-225-5200
  • Fax:
Mailing address:
  • Phone: 530-241-5816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126732
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: