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General NPI Number Information
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NPI Number | 1578832606
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Entity Type | Individual
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Provider Name | YALDA SOHA DC, LAC, DIPL. OM
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Gender | Female
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 14200 W CELEBRATE LIFE WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-3007
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Country | US
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Telephone | 623-207-3719
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Fax | 623-207-3611
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Provider Business Mailing Address
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Address Line | 14200 W CELEBRATE LIFE WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-3007
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Country | US
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Telephone | 623-207-3719
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Fax | 623-207-3611
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31521
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 13919
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License Number State | CA
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