Provider Demographics
NPI:1912505660
Name:SOLORIO, SARA EVANGELIA (BCBA)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:EVANGELIA
Last Name:SOLORIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:EVANGELIA
Other - Last Name:ZARGLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:16600 SHERMAN WAY # 178
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3875
Mailing Address - Country:US
Mailing Address - Phone:818-235-1414
Mailing Address - Fax:
Practice Address - Street 1:16600 SHERMAN WAY # 178
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3875
Practice Address - Country:US
Practice Address - Phone:818-235-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-20-44837103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst