MEDICARE: MS. RITA P. SORIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1235264979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RITA P. SORIA

Provider Business Mailing Address
First Line	:	425 PINE ST
Second Line	:	SUITE 2
City	:	GALT
State	:	CA
Zip	:	95632-2055
Country	:	US
Telephone Number	:	209-745-3101
Fax Number	:	209-745-7539

Provider Business Practice Location Address
First Line	:	425 PINE ST
Second Line	:	SUITE 2
City	:	GALT
State	:	CA
Zip	:	95632-2055
Country	:	US
Telephone Number	:	209-745-3101
Fax Number	:	209-745-7539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	01/04/2011

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