Provider Demographics
NPI:1417790460
Name:SORIANO, VICTORIA YSABEL
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:YSABEL
Last Name:SORIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 LOCKHILL SELMA RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CASTLE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1559
Mailing Address - Country:US
Mailing Address - Phone:210-643-1119
Mailing Address - Fax:
Practice Address - Street 1:1842 LOCKHILL SELMA RD STE 102
Practice Address - Street 2:
Practice Address - City:CASTLE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78213-1559
Practice Address - Country:US
Practice Address - Phone:210-643-1119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB943961106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician