Healthcare Provider Details

I. General information

NPI: 1881951358
Provider Name (Legal Business Name): ANGELICA SOTO BATCHELDER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELICA DIANE SOTO SOTO

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9511 SILVER STONE LN
OOLTEWAH TN
37363-3008
US

IV. Provider business mailing address

9511 SILVER STONE LN
OOLTEWAH TN
37363-3008
US

V. Phone/Fax

Practice location:
  • Phone: 951-776-6752
  • Fax:
Mailing address:
  • Phone: 951-776-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4209
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number32674
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number40091
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: