Individual provider Active NPI

Randall Patricio Torres, PSYD

  • Clinical Psychologist
  • Alpine, CA
National Provider Identifier
1871696435
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31823 Issued in CA
Practice address
2153 Arnold Way
Alpine, CA 91901-2157
Phone
(619) 995-6239
Fax
(619) 659-8187
NPI assigned
Sep 7, 2006
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSB32123 CA
Addiction (Substance Use Disorder) Psychologist 103TA0400X 31823 CA
Cognitive & Behavioral Psychologist 103TB0200X 31823 CA
Clinical Psychologist 103TC0700X PS31823 CA
Clinical Psychologist 103TC0700X 31823 CA
Clinical Psychologist 103TC0700X PSY31823 CA Primary
Group Psychotherapy Psychologist 103TP2701X 31823 CA

Addresses

Primary practice location

2153 Arnold Way
Alpine, CA 91901-2157

Mailing address

PO Box 182
Alpine, CA 91903-0182
Phone (619) 995-6239

Other names 1

  • Dr. Patricio Randal Torres Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220422000984 CA Practitioner - Clinical Psychologist 2668869520 Reassigns benefits to 1 organization
Practice locations: Alpine, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1620 Alpine Blvd
Suite 110
Alpine, CA 91901-1103
Phone (619) 662-4100

1912 Arnold Way
Alpine, CA 91901-2144
Phone (619) 995-6239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSB32123CAMDPsychologist
PS31823CAMDClinical Psychologist
PSY31823CAMDClinical Psychologist
31823CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Aug 10, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Aug 10, 2024 Accepting new patients

Locations

1620 Alpine Blvd
Ste 110
Alpine, CA 91901
Phone (760) 350-9725

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1871696435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919030182",
            "telephone_number": "619-995-6239",
            "fax_number": "619-659-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 ARNOLD WAY",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919012157",
            "telephone_number": "619-995-6239",
            "fax_number": "619-659-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "RANDALL",
        "middle_name": "PATRICIO",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-09-23",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB32123",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "31823",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "31823",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PS31823",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31823",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31823",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "31823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIO",
            "last_name": "TORRES",
            "middle_name": "RANDAL",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alpine, CA

Sources for this page

Verify at the official NPI Registry.