Provider Demographics
NPI:1720576481
Name:SOTO, SALOME ANNE (NP)
Entity Type:Individual
Prefix:
First Name:SALOME
Middle Name:ANNE
Last Name:SOTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 W SAN RAMON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2633
Mailing Address - Country:US
Mailing Address - Phone:559-360-5648
Mailing Address - Fax:
Practice Address - Street 1:7230 N MILLBROOK AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3340
Practice Address - Country:US
Practice Address - Phone:559-431-6197
Practice Address - Fax:559-431-8827
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95008942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95008942OtherBOARD OF REGISTERED NURSING NURSE PRACTITIONER FURNISHING
CA95008942OtherBOARD OF REGISTERED NURSING NURSE PRACTITIONER
TXF03180477OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS