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NPI Code Detail

MEDICARE: MARIO TORRES

MEDICARE:   MARIO  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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1770904245
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO TORRES
Provider Business Mailing Address
First Line : 16782 VON KARMAN AVE STE 11
Second Line :
City : IRVINE
State : CA
Zip : 92606-2417
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-550-6368
Provider Business Practice Location Address
First Line : 12604 HIDDENCREEK WAY STE C
Second Line :
City : CERRITOS
State : CA
Zip : 90703-2137
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-550-6368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2013
Last Update Date : 02/10/2022

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Directions to “ MARIO TORRES ” Practice Location

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