Provider Demographics
NPI:1194098152
Name:SOLORIO, ISELA
Entity type:Individual
Prefix:
First Name:ISELA
Middle Name:
Last Name:SOLORIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 CHERI DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-2601
Mailing Address - Country:US
Mailing Address - Phone:562-245-7782
Mailing Address - Fax:562-245-7346
Practice Address - Street 1:1171 CHERI DR
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-2601
Practice Address - Country:US
Practice Address - Phone:562-245-7782
Practice Address - Fax:562-245-7346
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50000-59999Medicaid