Healthcare Provider Details

I. General information

NPI: 1477038677
Provider Name (Legal Business Name): OSCAR SOLTERO NCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S OAK KNOLL AVE
PASADENA CA
91106-3809
US

IV. Provider business mailing address

717 S OAK KNOLL AVE
PASADENA CA
91106-3809
US

V. Phone/Fax

Practice location:
  • Phone: 818-430-1894
  • Fax:
Mailing address:
  • Phone: 818-430-1894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number130181712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: