Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 11040 | FL |
N | 103TC0700X | Clinical Psychologist | 11040 | FL |
Y | 103G00000X | Clinical Psychologist | 33037 | CA |
Y | 103TC0700X | Clinical Psychologist | 33037 | CA |
NPI | 1003587858 |
---|---|
Provider Name | Rayda Anaya-Soto |
First Address | Winter Haven, FL 33881-2660 |
Second Address | San Diego, CA 92128-2431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2021 |
Last Update Date | 08/12/2021 |