Healthcare Provider Details

I. General information

NPI: 1780821025
Provider Name (Legal Business Name): PATRICIA SOTO PSC-B
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28050 ROAD 148
VISALIA CA
93292-9297
US

IV. Provider business mailing address

PO BOX 5091
VISALIA CA
93278-5091
US

V. Phone/Fax

Practice location:
  • Phone: 559-747-3984
  • Fax: 559-747-3642
Mailing address:
  • Phone: 559-747-3984
  • Fax: 559-747-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: