Provider Demographics
NPI:1114088432
Name:HERNANDEZ-SOTO, ANA M (ASW)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:HERNANDEZ-SOTO
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BECK AVE # MS 5120
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6804
Mailing Address - Country:US
Mailing Address - Phone:707-784-8140
Mailing Address - Fax:707-428-6542
Practice Address - Street 1:275 BECK AVE # MS 5120
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6804
Practice Address - Country:US
Practice Address - Phone:707-784-8140
Practice Address - Fax:707-428-6542
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31265101YM0800X
CA115212104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health