Provider Demographics
NPI:1932502333
Name:SOTOMAYOR, BETTY CASTRO (LMFT LICENSE #93809)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:CASTRO
Last Name:SOTOMAYOR
Suffix:
Gender:F
Credentials:LMFT LICENSE #93809
Other - Prefix:
Other - First Name:YADHIRA
Other - Middle Name:BERENICE
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT LICENSE #93809
Mailing Address - Street 1:25201 AVENUE TIBBITTS
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:661-347-6886
Mailing Address - Fax:
Practice Address - Street 1:23236 LYONS AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2635
Practice Address - Country:US
Practice Address - Phone:661-347-6886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF66772106H00000X
CA93809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA93809OtherLMFT