Provider Demographics
NPI:1548037013
Name:TORRES DIAZ, DEREK GAMALIER
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:GAMALIER
Last Name:TORRES DIAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 INCA ST UNIT 533
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-2894
Mailing Address - Country:US
Mailing Address - Phone:787-238-7895
Mailing Address - Fax:
Practice Address - Street 1:899 N LOGAN ST STE 311
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3155
Practice Address - Country:US
Practice Address - Phone:720-551-8382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health