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NPI Code Detail

MEDICARE: STEPHANIE SOTO M.A., LPCC, NCC

MEDICARE: STEPHANIE SOTO M.A., LPCC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor16400CA

General Provider Information

NPI Number : 1205390820
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE SOTO M.A., LPCC, NCC
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 5472 EL CAJON BLVD # 101
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-3622
Country : US
Telephone Number : 619-269-0836
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2019
Last Update Date : 10/30/2024

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