Provider Demographics
NPI:1659997153
Name:TORRICER, CHARLOTTE TABUYO (RN)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:TABUYO
Last Name:TORRICER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 EL PASO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-3116
Mailing Address - Country:US
Mailing Address - Phone:701-339-0866
Mailing Address - Fax:
Practice Address - Street 1:891 EL PASO DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-3116
Practice Address - Country:US
Practice Address - Phone:701-339-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95110488163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDTOR-83-4301OtherDRIVERS LICENSE