Healthcare Provider Details

I. General information

NPI: 1831348895
Provider Name (Legal Business Name): JESSICA TORRES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA RODRIGUEZ

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FOSTER RD
SANTA MARIA CA
93455-3620
US

IV. Provider business mailing address

212 CARMEN LN
SANTA MARIA CA
93458-7769
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-6381
  • Fax:
Mailing address:
  • Phone: 805-739-8700
  • Fax: 805-739-8647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number63436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: