=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417870890
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAZMIN ALVARADO SOTO LGSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2026
-----------------------------------------------------
Last Update Date | 08/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1903 GREELEY ST S STE 202
-----------------------------------------------------
City | STILLWATER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55082-6279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-234-2644
-----------------------------------------------------
Fax | 651-390-5503
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 202 N CEDAR AVE STE 1
-----------------------------------------------------
City | OWATONNA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55060-2306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-503-6903
-----------------------------------------------------
Fax | 651-390-5503
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 29800
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------