MEDICARE: MARIANA SOLIS-IBARRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	157597	CA

General Provider Information

NPI Number	:	1285094326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANA SOLIS-IBARRA

Provider Business Mailing Address
First Line	:	1704 W MANCHESTER AVE STE 202A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3057
Country	:	US
Telephone Number	:	760-234-4487
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 W MANCHESTER AVE STE 202A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3057
Country	:	US
Telephone Number	:	760-234-4487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	10/02/2025

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Directions to “ MARIANA SOLIS-IBARRA ” Practice Location

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