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General NPI Number Information
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NPI Number | 1720499510
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Entity Type | Individual
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Provider Name | RUBY TORRES
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Gender | Female
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 2484 MEDALLION DR
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City | UNION CITY
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State | CA
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Zip | 94587-1934
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Country | US
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Telephone | 510-487-8227
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Fax | 510-431-3475
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Provider Business Mailing Address
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Address Line | 2484 MEDALLION DR
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City | UNION CITY
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State | CA
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Zip | 94587-1934
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Country | US
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Telephone | 510-487-8158
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Fax | 510-431-3475
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 015600705
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License Number State | CA
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