Healthcare Provider Details

I. General information

NPI: 1326779059
Provider Name (Legal Business Name): VANESSA PAMELA SOTO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E MAIN ST
SANTA PAULA CA
93060-2748
US

IV. Provider business mailing address

PO BOX 5273
VENTURA CA
93005-0273
US

V. Phone/Fax

Practice location:
  • Phone: 805-933-8440
  • Fax:
Mailing address:
  • Phone: 805-366-8142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: