Healthcare Provider Details

I. General information

NPI: 1366821498
Provider Name (Legal Business Name): ROSALICIA D TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E BEACH ST
WATSONVILLE CA
95076-4809
US

IV. Provider business mailing address

204 E BEACH ST
WATSONVILLE CA
95076-4809
US

V. Phone/Fax

Practice location:
  • Phone: 831-728-0222
  • Fax: 831-202-2777
Mailing address:
  • Phone: 831-728-0222
  • Fax: 831-202-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number171749
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2018-0704
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: