Healthcare Provider Details

I. General information

NPI: 1467024521
Provider Name (Legal Business Name): WILMA RUTH TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 08/13/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S FAIR OAKS AVE DEPT 1
SUNNYVALE CA
94086-7913
US

IV. Provider business mailing address

660 S FAIR OAKS AVE FL 1
SUNNYVALE CA
94086-7913
US

V. Phone/Fax

Practice location:
  • Phone: 408-610-0818
  • Fax:
Mailing address:
  • Phone: 408-992-4917
  • Fax: 408-992-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number805073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: