=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124172994
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VERONICA TORRES CPNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2007
-----------------------------------------------------
Last Update Date | 11/14/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12820 PIONEER BLVD
-----------------------------------------------------
City | NORWALK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90650-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-868-0431
-----------------------------------------------------
Fax | 562-981-8114
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4760 COLDBROOK AVE
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90713-2316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-421-2650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 536146
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------