Healthcare Provider Details

I. General information

NPI: 1033075833
Provider Name (Legal Business Name): ZOE ROSE SOLACE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 12/25/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 W SHAW AVE STE 102
FRESNO CA
93711-3229
US

IV. Provider business mailing address

PO BOX 5302
FRESNO CA
93755-5302
US

V. Phone/Fax

Practice location:
  • Phone: 559-374-3990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT144996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: