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General NPI Number Information
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NPI Number | 1902297369
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Entity Type | Individual
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Provider Name | NANCY DE LA TORRE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 12510 VAN NUYS BLVD STE 201
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City | PACOIMA
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State | CA
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Zip | 91331-6732
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Country | US
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Telephone | 818-896-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W WALNUT ST STE 375
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City | PASADENA
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State | CA
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Zip | 91103-3744
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Country | US
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Telephone | 626-395-7100
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW71999
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 97910
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW97910
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License Number State | CA
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