Healthcare Provider Details

I. General information

NPI: 1184026361
Provider Name (Legal Business Name): ALLISON DE LA TORRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BERCUT DR
SACRAMENTO CA
95811-0131
US

IV. Provider business mailing address

3780 ROSIN CT STE 110
SACRAMENTO CA
95834-1698
US

V. Phone/Fax

Practice location:
  • Phone: 916-440-1500
  • Fax: 916-440-1514
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136610
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: