Healthcare Provider Details

I. General information

NPI: 1265093298
Provider Name (Legal Business Name): MARINA ELENA TORAL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 E MAIN ST STE 300
STOCKTON CA
95202-2908
US

IV. Provider business mailing address

2221 KIMES RANCH RD
PATTERSON CA
95363-2675
US

V. Phone/Fax

Practice location:
  • Phone: 209-478-4554
  • Fax:
Mailing address:
  • Phone: 209-221-9378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2470A2800X
TaxonomyAssistant Health Information Record Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: