Provider Demographics
NPI:1215366554
Name:SOTO, MARIA D (AMFT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:SOTO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 MACHADO LN
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-8800
Mailing Address - Country:US
Mailing Address - Phone:310-737-9393
Mailing Address - Fax:310-737-7944
Practice Address - Street 1:5350 MACHADO LN
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-8800
Practice Address - Country:US
Practice Address - Phone:310-737-9393
Practice Address - Fax:310-737-7944
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106214106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDI-CAL