Healthcare Provider Details

I. General information

NPI: 1831610583
Provider Name (Legal Business Name): DORI DENAY SOTELO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 DAY CREEK BLVD
RANCHO CUCAMONGA CA
91739-9329
US

IV. Provider business mailing address

8160 DAY CREEK BLVD
RANCHO CUCAMONGA CA
91739-9329
US

V. Phone/Fax

Practice location:
  • Phone: 626-391-1221
  • Fax:
Mailing address:
  • Phone: 626-391-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW108535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: