Healthcare Provider Details

I. General information

NPI: 1417935255
Provider Name (Legal Business Name): MATTHEW F SOULIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 IRON POINT RD
FOLSOM CA
95630-8013
US

IV. Provider business mailing address

1050 IRON POINT RD
FOLSOM CA
95630-8013
US

V. Phone/Fax

Practice location:
  • Phone: 916-597-2340
  • Fax: 916-597-2341
Mailing address:
  • Phone: 916-597-2340
  • Fax: 916-597-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number224157
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberA105316
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: