Healthcare Provider Details

I. General information

NPI: 1538091764
Provider Name (Legal Business Name): DENNIS SOTTO PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 TUOLUMNE ST
VALLEJO CA
94589-2523
US

IV. Provider business mailing address

43855 SPRING ST
LANCASTER CA
93536-2517
US

V. Phone/Fax

Practice location:
  • Phone: 707-644-7401
  • Fax:
Mailing address:
  • Phone: 661-470-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA48671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: