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General NPI Number Information
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NPI Number | 1700757028
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY SOMERA
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Gender | Male
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 3200 TULLY RD
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City | MODESTO
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State | CA
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Zip | 95350-0811
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Country | US
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Telephone | 209-576-2283
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Fax |
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Provider Business Mailing Address
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Address Line | 13717 S UNION RD
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City | MANTECA
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State | CA
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Zip | 95336-9281
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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