MEDICARE: MARLENE TORRES PPS-220186895

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	101YS0200X	School Counselor	PPS-220186895	CA

General Provider Information

NPI Number	:	1053291450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE TORRES PPS-220186895

Provider Business Mailing Address
First Line	:	12555 NAVAJO RD
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-7256
Country	:	US
Telephone Number	:	760-247-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	21950 NISQUALLY RD
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-5770
Country	:	US
Telephone Number	:	760-240-4252
Fax Number	:

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

Provider Enumeration Date	:	09/05/2025
Last Update Date	:	09/05/2025

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