Healthcare Provider Details

I. General information

NPI: 1649697970
Provider Name (Legal Business Name): ELSA LISSETH TORRES PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W SANTA ANA BLVD STE 600
SANTA ANA CA
92701-4552
US

IV. Provider business mailing address

600 W SANTA ANA BLVD STE 600
SANTA ANA CA
92701-4552
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-4455
  • Fax: 714-542-2793
Mailing address:
  • Phone: 714-953-4455
  • Fax: 714-542-2793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105653
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: