Individual
JORGE RENE SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
3115 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 600-2382
Mailing address
3433 W SHAW AVE STE 108, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36461
CA
Other
Enumeration date
04/24/2024
Last updated
05/13/2026
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