Active NPI
Syrett Yvonne Torres, PSY,D,
- Clinical Psychologist
- Gresham, OR
National Provider Identifier
1790036366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2502
- Practice address
- 600 NE 8TH St
Gresham, OR 97030-7317 - Phone
- (503) 988-5155
- Fax
- (503) 988-5185
- NPI assigned
- Sep 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2502 | OR | Primary |
Addresses
Primary practice location
600 NE 8TH St
Gresham, OR 97030-7317
Mailing address
421 SW Oak St
Ste. 210
Portland, OR 97204-1817
Phone (503) 988-7468
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096511 | Medicaid | OR | |
| 022959 | Medicaid | OR |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457568000000",
"number": "1790036366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 SW OAK ST",
"address_2": "STE. 210",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972041817",
"telephone_number": "503-988-7468",
"fax_number": "503-988-3015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 NE 8TH ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307317",
"telephone_number": "503-988-5155",
"fax_number": "503-988-5185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORRES",
"first_name": "SYRETT",
"middle_name": "YVONNE",
"name_prefix": "Dr.",
"credential": "PSY,D,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-24",
"last_updated": "2016-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "096511",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022959",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.