Provider Demographics
NPI:1962154666
Name:SOLIS, CAITLYN J
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:J
Last Name:SOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:JEAN
Other - Last Name:NEDROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3180 MIRA MESA AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4323
Mailing Address - Country:US
Mailing Address - Phone:760-390-4695
Mailing Address - Fax:
Practice Address - Street 1:3186 AIRWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4650
Practice Address - Country:US
Practice Address - Phone:714-881-0427
Practice Address - Fax:714-327-0673
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst