Provider Demographics
NPI:1285141507
Name:SOLIS, ABIGAIL (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 N MARENGO AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1955
Mailing Address - Country:US
Mailing Address - Phone:626-532-2436
Mailing Address - Fax:
Practice Address - Street 1:15643 SHERMAN WAY STE 440
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4149
Practice Address - Country:US
Practice Address - Phone:626-531-6999
Practice Address - Fax:626-531-6998
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-28151103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst