MEDICARE: ROSA TORRES

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	1041C0700X	Clinical Social Worker	25491	CA
2	101YM0800X	Mental Health Counselor	17377	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25491	OTHER	CA	BBS - LCSW
2	17377	OTHER	CA	ACSW

General Provider Information

NPI Number	:	1356421523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA TORRES

Provider Business Mailing Address
First Line	:	4701 E CESAR E CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1209
Country	:	US
Telephone Number	:	323-267-3400
Fax Number	:	323-260-5201

Provider Business Practice Location Address
First Line	:	4701 E CESAR E CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1209
Country	:	US
Telephone Number	:	323-267-3400
Fax Number	:	323-260-5201

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	02/26/2021

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Directions to “ ROSA TORRES ” Practice Location

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