Provider Demographics
NPI:1609400126
Name:SOTO, CYTTIRAE
Entity Type:Individual
Prefix:
First Name:CYTTIRAE
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 W 16TH ST # 96
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-4536
Mailing Address - Country:US
Mailing Address - Phone:209-201-4840
Mailing Address - Fax:
Practice Address - Street 1:2808 PARK AVE STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3392
Practice Address - Country:US
Practice Address - Phone:209-308-5009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician