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General NPI Number Information
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NPI Number | 1003587858
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Entity Type | Individual
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Provider Name | RAYDA ANAYA-SOTO
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 11650 IBERIA PL STE 130
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City | SAN DIEGO
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State | CA
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Zip | 92128-2431
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Country | US
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Telephone | 858-264-5858
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Fax | 858-649-6012
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Provider Business Mailing Address
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Address Line | 1550 11TH ST NE APT D5
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City | WINTER HAVEN
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State | FL
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Zip | 33881-2660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 11040
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33037
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License Number State | CA
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