Basic Information
| Provider Information | |||||||||
| NPI: | 1760686265 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | XOLEDAD | ||||||||
| MiddleName: | ANNAMARIA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. IMF | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1266 14TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946072247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102734700 | ||||||||
| FaxNumber: | 5105308083 | ||||||||
| Practice Location | |||||||||
| Address1: | 1266 14TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946072247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104734700 | ||||||||
| FaxNumber: | 5105308083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 06/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 67928 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 49274 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 90998 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.