VANESSA ICAZBALCETA-SOTO
NPI 1083264519
Counselor - Professional in San Diego, CA

Q: What is Vanessa Icazbalceta-soto's NPI number?

The NPI number for Vanessa Icazbalceta-soto is 1083264519. It was assigned to this individual provider in the NPPES registry on September 17, 2019. The provider is also known as Vanessa Icazbalceta.

Q: What is Vanessa Icazbalceta-soto's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since September 17, 2019PECOS Enrolled

9265 SKY PARK CT STE 100, SAN DIEGO, CA 92123(706) 524-7134 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Apr 25, 2024, Sep 17, 2019 (2 updates tracked since 2019).

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About Vanessa Icazbalceta-soto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VANESSA ICAZBALCETA-SOTO (NPI 1083264519) is an individual professional provider in San Diego, California, licensed in California (15849) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1083264519

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameVANESSA ICAZBALCETA-SOTO

Location Address9265 SKY PARK CT STE 100San Diego, CA 92123-4375

Mailing Address201 N Brand Blvd #200Los Angeles, CA 91203-1519 · (562) 888-0285

Phone(706) 524-7134

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateSeptember 17, 2019

Last NPPES UpdateOctober 16, 20242 updates tracked since enumeration

NPPES CertifiedOctober 16, 2024

✔ NPI 1083264519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in CA · 15849

9265 SKY PARK CT STE 100, San Diego, CA 92123

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Other Names 1

Former Name (1)Vanessa Icazbalceta

Secondary Practice Location 1

Location 1201 N Brand Blvd Unit 200Los Angeles, CA 91203 · Phone (562) 888-0285

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vanessa Icazbalceta-soto is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173061579

PECOS Enrollment IDI20260603003903

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BENIGNO QUIRARTE M.S.

Marriage & Family Therapist