Provider Demographics
NPI:1225693351
Name:SOTO SALAZAR, IVETTE EVELYN (FNP)
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:EVELYN
Last Name:SOTO SALAZAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 N FAIR OAKS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1876
Mailing Address - Country:US
Mailing Address - Phone:626-398-0354
Mailing Address - Fax:
Practice Address - Street 1:1403 N FAIR OAKS AVE STE 3
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1876
Practice Address - Country:US
Practice Address - Phone:626-398-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95037181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily