Provider Demographics
NPI:1578394342
Name:TORRES, MYRTHA NOEMI
Entity type:Individual
Prefix:MS
First Name:MYRTHA
Middle Name:NOEMI
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 S MADERA AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5576
Mailing Address - Country:US
Mailing Address - Phone:559-664-1600
Mailing Address - Fax:
Practice Address - Street 1:28261 AVENUE 14
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-4906
Practice Address - Country:US
Practice Address - Phone:559-664-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200184022101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool