Healthcare Provider Details

I. General information

NPI: 1124940226
Provider Name (Legal Business Name): LETICIA DIANE TORRES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

26001 REDLANDS BLVD
REDLANDS CA
92373-7762
US

IV. Provider business mailing address

34038 AVENUE I
YUCAIPA CA
92399-2618
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax: 937-230-2472
Mailing address:
  • Phone: 909-225-3792
  • Fax: 937-230-2472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95073191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: