Provider Demographics
NPI:1992135701
Name:SOLORIO, MARIA ELENA (MA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:SOLORIO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 HOLLISTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-3525
Mailing Address - Country:US
Mailing Address - Phone:818-744-2285
Mailing Address - Fax:
Practice Address - Street 1:16946 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3613
Practice Address - Country:US
Practice Address - Phone:818-401-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-29260103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst