Healthcare Provider Details

I. General information

NPI: 1750111209
Provider Name (Legal Business Name): ALONDRA TORREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6474 LINDA LEE DR APT C
YUCCA VALLEY CA
92284-2988
US

IV. Provider business mailing address

PO BOX 1842
YUCCA VALLEY CA
92286-1842
US

V. Phone/Fax

Practice location:
  • Phone: 832-317-1519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW114048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: