Provider Demographics
NPI:1689702425
Name:SOTO, GLADYS HOLDER (CATC)
Entity Type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:HOLDER
Last Name:SOTO
Suffix:
Gender:F
Credentials:CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 GENEBERN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1123
Mailing Address - Country:US
Mailing Address - Phone:415-584-4395
Mailing Address - Fax:415-826-6774
Practice Address - Street 1:820 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1737
Practice Address - Country:US
Practice Address - Phone:415-920-0720
Practice Address - Fax:415-826-6774
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA970213101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)