Healthcare Provider Details

I. General information

NPI: 1669990727
Provider Name (Legal Business Name): YASMIN A SOTO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PRESCOTT ST
WORCESTER MA
01605-2610
US

IV. Provider business mailing address

85 PRESCOTT ST
WORCESTER MA
01605-2610
US

V. Phone/Fax

Practice location:
  • Phone: 774-420-2611
  • Fax:
Mailing address:
  • Phone: 774-420-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2318100
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: