Provider Demographics
NPI:1922897503
Name:SOTO, SAVANNAH XIANA
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:XIANA
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 1:2560 MIDGE AVE APT 91
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-3188
Mailing Address - Country:US
Mailing Address - Phone:831-272-9669
Mailing Address - Fax:209-318-1380
Practice Address - Street 1:547 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4715
Practice Address - Country:US
Practice Address - Phone:209-906-2318
Practice Address - Fax:209-906-2318
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY7726283171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator