Provider Demographics
NPI:1861049041
Name:SOTO GONZALEZ, PAMELA E (LPCC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:E
Last Name:SOTO GONZALEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 E BABCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-2325
Mailing Address - Country:US
Mailing Address - Phone:559-429-5584
Mailing Address - Fax:
Practice Address - Street 1:516 N KAWEAH AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1200
Practice Address - Country:US
Practice Address - Phone:559-594-4969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional