Provider Demographics
NPI:1962388363
Name:DE LA TORRE, PATRICIA M (PPS)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 W ALWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3259
Mailing Address - Country:US
Mailing Address - Phone:626-856-1693
Mailing Address - Fax:626-480-7125
Practice Address - Street 1:2021 W ALWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3259
Practice Address - Country:US
Practice Address - Phone:626-856-1693
Practice Address - Fax:626-480-7125
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230212191101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool