Healthcare Provider Details

I. General information

NPI: 1386577989
Provider Name (Legal Business Name): JUSTIN TORRES PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 COBURG RD UNIT 301
EUGENE OR
97401-4900
US

IV. Provider business mailing address

332 FILMORE DR
JACKSONVILLE FL
32225-3390
US

V. Phone/Fax

Practice location:
  • Phone: 888-468-9669
  • Fax:
Mailing address:
  • Phone: 904-416-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10058393
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9488025
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: