Provider Demographics
NPI:1104690858
Name:SOLANO, JENAI (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JENAI
Middle Name:
Last Name:SOLANO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12588 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-2708
Mailing Address - Country:US
Mailing Address - Phone:760-662-7511
Mailing Address - Fax:
Practice Address - Street 1:112588 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-2708
Practice Address - Country:US
Practice Address - Phone:760-662-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-23-66089103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst