Provider Demographics
NPI:1215087945
Name:SOLOMON, ENID I (MFT)
Entity type:Individual
Prefix:
First Name:ENID
Middle Name:I
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 EMERSON ST
Mailing Address - Street 2:#8
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 E LELAND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4960
Practice Address - Country:US
Practice Address - Phone:925-439-9628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44026106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist