Individual provider Active NPI

Imelda Daclag Torres

  • Adult Psychiatric/Mental Health Registered Nurse
  • Cherryland, CA
National Provider Identifier
1588479745
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
641959 Issued in CA
Practice address
494 Blossom Way
Cherryland, CA 94541-1948
Phone
(510) 582-7676
Fax
(510) 582-0467
NPI assigned
Feb 12, 2025
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 641959 CA Primary

Addresses

Primary practice location

494 Blossom Way
Cherryland, CA 94541-1948

Mailing address

2222 Sandpiper CT
San Leandro, CA 94579-2753
Phone (510) 329-6162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
641959CAMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1588479745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SANDPIPER CT",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945792753",
            "telephone_number": "510-329-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 BLOSSOM WAY",
            "city": "CHERRYLAND",
            "state": "CA",
            "postal_code": "945411948",
            "telephone_number": "510-582-7676",
            "fax_number": "510-582-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "IMELDA",
        "middle_name": "DACLAG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "641959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherryland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.