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General NPI Number Information
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NPI Number | 1285282426
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Entity Type | Individual
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Provider Name | AMANDA TORRE MFT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 9625 BLACK MOUNTAIN RD STE 307-3
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City | SAN DIEGO
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State | CA
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Zip | 92126-4564
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Country | US
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Telephone | 619-732-6185
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Fax |
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Provider Business Mailing Address
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Address Line | 10606-8 CAMINO RUIZ #241
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City | SAN DIEGO
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State | CA
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Zip | 92126
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Country | US
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Telephone | 619-732-6185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 88617
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License Number State | CA
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