Healthcare Provider Details

I. General information

NPI: 1497446298
Provider Name (Legal Business Name): ELIZABETH SOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date: 03/06/2024
Reactivation Date: 07/17/2026

III. Provider practice location address

27555 YNEZ RD STE 300
TEMECULA CA
92591-4678
US

IV. Provider business mailing address

236 W 1ST ST
PERRIS CA
92570-2001
US

V. Phone/Fax

Practice location:
  • Phone: 951-466-3196
  • Fax:
Mailing address:
  • Phone: 951-466-3196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: