Provider Demographics
NPI:1508015702
Name:SOTO, NORA GONZALEZ (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:GONZALEZ
Last Name:SOTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11290 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2706
Mailing Address - Country:US
Mailing Address - Phone:951-509-8733
Mailing Address - Fax:951-509-8479
Practice Address - Street 1:11290 PIERCE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-2706
Practice Address - Country:US
Practice Address - Phone:951-509-8733
Practice Address - Fax:951-509-8479
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical