Provider Demographics
NPI:1841783859
Name:SOTTO, CESAR CADAVEZ III (LVN)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:CADAVEZ
Last Name:SOTTO
Suffix:III
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9049 FOUR SEASONS DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4099
Mailing Address - Country:US
Mailing Address - Phone:916-768-7632
Mailing Address - Fax:
Practice Address - Street 1:9049 FOUR SEASONS DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4099
Practice Address - Country:US
Practice Address - Phone:916-768-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN276801164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse