Healthcare Provider Details

I. General information

NPI: 1316441165
Provider Name (Legal Business Name): ALICIA TORRES MACP, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ALTA RD
SAN DIEGO CA
92179-0001
US

IV. Provider business mailing address

480 ALTA RD
SAN DIEGO CA
92179-0001
US

V. Phone/Fax

Practice location:
  • Phone: 619-661-6500
  • Fax:
Mailing address:
  • Phone: 619-661-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: