Provider Demographics
NPI:1154944650
Name:SOTO, GRISELDA JANET (MSW ASW)
Entity type:Individual
Prefix:
First Name:GRISELDA
Middle Name:JANET
Last Name:SOTO
Suffix:
Gender:F
Credentials:MSW ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 ALUM AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-6579
Mailing Address - Country:US
Mailing Address - Phone:661-496-8404
Mailing Address - Fax:
Practice Address - Street 1:1300 17TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4504
Practice Address - Country:US
Practice Address - Phone:661-852-5660
Practice Address - Fax:661-852-5694
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW875251041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool