Individual ProviderIlse SotoBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address510 Civic Center Dr Ste D, Vista, CA 92084-6169(760) 691-9622PECOS EnrollmentBased on the most recent information from CMS, provider Ilse Soto does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1831607977Provider TypeIndividualFull NameSoto, IlseCredentialMAGenderFemaleSole ProprietorNoEnumeration Date1/10/2018Last Updated12/7/2021Contact InformationPractice LocationPractice Address510 Civic Center Dr Ste D, Vista, CA 92084-6169Phone(760) 691-9622FaxUnlisted FaxMailing LocationMailing Address562 W Grand Ave, Escondido, CA 92025-2502Phone(760) 691-9622Fax(442) 999-5740Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicense1-21-51963CaliforniaCode247200000XDescriptionTechnician, OtherTechnologists, Technicians & Other Technical Service ProvidersLicenseUnlisted Issuer