Healthcare Provider Details

I. General information

NPI: 1063346104
Provider Name (Legal Business Name): MANUEL TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E REDLANDS BLVD STE 298
REDLANDS CA
92373-4722
US

IV. Provider business mailing address

17151 MAIN ST STE C
HESPERIA CA
92345-6191
US

V. Phone/Fax

Practice location:
  • Phone: 909-413-4304
  • Fax:
Mailing address:
  • Phone: 760-780-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: