MEDICARE: MS. SUSAN WINTER TORMA MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFT14995	CA

General Provider Information

NPI Number	:	1013982255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN WINTER TORMA MFT

Provider Business Mailing Address
First Line	:	6741 TOWN VIEW CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-1743
Country	:	US
Telephone Number	:	619-583-6898
Fax Number	:

Provider Business Practice Location Address
First Line	:	6475 ALVARADO RD
Second Line	:	STE 233
City	:	SAN DIEGO
State	:	CA
Zip	:	92120
Country	:	US
Telephone Number	:	858-279-1223
Fax Number	:	619-229-2333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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