Provider Demographics
NPI:1053763029
Name:TORREZ, DANIELLE KATHLEEN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KATHLEEN
Last Name:TORREZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4922
Mailing Address - Country:US
Mailing Address - Phone:909-747-5930
Mailing Address - Fax:
Practice Address - Street 1:1618 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4922
Practice Address - Country:US
Practice Address - Phone:909-747-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist