Provider Demographics
NPI:1124066014
Name:SOLANO, GLORIA (RN CNS)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:SOLANO
Suffix:
Gender:F
Credentials:RN CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 609001
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-9001
Mailing Address - Country:US
Mailing Address - Phone:619-528-4600
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 970
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1234
Practice Address - Country:US
Practice Address - Phone:858-558-2731
Practice Address - Fax:858-452-5905
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN505704163W00000X
CACNS1710364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
S59836Medicare UPIN
CAWCNS1710AMedicare PIN
CAW416Medicare PIN