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General NPI Number Information
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NPI Number | 1316565856
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Entity Type | Individual
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Provider Name | DINA TAMARA TORRES
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Gender | Female
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Dates
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Enumeration Date | 07/10/2020
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 5535 BALBOA BLVD STE 220
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City | ENCINO
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State | CA
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Zip | 91316-1553
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Country | US
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Telephone | 818-728-4212
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Fax |
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Provider Business Mailing Address
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Address Line | 338 W MAGNOLIA ST APT 2
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City | COMPTON
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State | CA
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Zip | 90220-2181
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Country | US
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Telephone | 310-625-9447
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 272239956
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License Number State | CA
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