Provider Demographics
NPI:1720508849
Name:SOTO MONDRAGON-HILL, ADRIANA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:SOTO MONDRAGON-HILL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:MONDRAGON-HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:2833 N BRISTOL ST APT 13B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1039
Mailing Address - Country:US
Mailing Address - Phone:714-681-0887
Mailing Address - Fax:
Practice Address - Street 1:222 FASHION LN STE 115
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3317
Practice Address - Country:US
Practice Address - Phone:714-681-0887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT117095106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417373226OtherMEDI-CAL