Healthcare Provider Details

I. General information

NPI: 1932327111
Provider Name (Legal Business Name): MS. IRENE SOLORZANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S 33RD DR
YUMA AZ
85364-9136
US

IV. Provider business mailing address

1537 S. 37TH AVE
YUMA AZ
85364-9136
US

V. Phone/Fax

Practice location:
  • Phone: 928-257-2298
  • Fax:
Mailing address:
  • Phone: 928-318-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number12031
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number12031
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: