Healthcare Provider Details

I. General information

NPI: 1982186326
Provider Name (Legal Business Name): KARLA SOLIS RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2018
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 W 110TH ST
LOS ANGELES CA
90061-2013
US

IV. Provider business mailing address

742 N. LA BREA
INGLEWOOD CA
90302
US

V. Phone/Fax

Practice location:
  • Phone: 562-331-9452
  • Fax:
Mailing address:
  • Phone: 562-331-9452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number95376275
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95376275
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95376275
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95376275
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN68803
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number95376275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: