Provider Demographics
NPI:1396408787
Name:MUNOZ, MARGARITA SOTO (MA)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:SOTO
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-3917
Mailing Address - Country:US
Mailing Address - Phone:760-454-6882
Mailing Address - Fax:
Practice Address - Street 1:979 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-3917
Practice Address - Country:US
Practice Address - Phone:760-454-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-17-36415106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician