Basic Information
| Provider Information | |||||||||
| NPI: | 1861561433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRIETO | ||||||||
| FirstName: | SOFIA | ||||||||
| MiddleName: | CASTANEDA | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 490 S FARRELL DR STE C208 | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922627944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603254088 | ||||||||
| FaxNumber: | 7607783781 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 S FARRELL DR | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922627905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604161360 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 43448 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.