Individual
MICAHEL ANTHONY SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
(626) 962-4471
Mailing address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
(626) 962-4471
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT40658
CA
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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