Provider Demographics
NPI:1669805032
Name:SOTO, JANET
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:SOTO
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 1:2212 PEYTON AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2732
Mailing Address - Country:US
Mailing Address - Phone:213-256-1918
Mailing Address - Fax:
Practice Address - Street 1:1666 RAMONA AVE STE D
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2203
Practice Address - Country:US
Practice Address - Phone:805-473-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118947101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953144808OtherSANTA MARIA VALLEY YOUTH AND FAMILY CENTER
CA95-2633765Medicaid