Healthcare Provider Details

I. General information

NPI: 1770393423
Provider Name (Legal Business Name): SOTERIA BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 N LA BREA AVE FL 2
INGLEWOOD CA
90302-2207
US

IV. Provider business mailing address

965 N LA BREA AVE FL 2
INGLEWOOD CA
90302-2207
US

V. Phone/Fax

Practice location:
  • Phone: 310-672-6200
  • Fax: 888-293-8686
Mailing address:
  • Phone: 310-672-6200
  • Fax: 888-293-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CALVIN MYLES CARRERA
Title or Position: COO
Credential: MS
Phone: 310-955-0025