Healthcare Provider Details

I. General information

NPI: 1295696433
Provider Name (Legal Business Name): MARRIAH JESSICA WOODS SOLIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 ROAD 35
MADERA CA
93636-8487
US

IV. Provider business mailing address

645 W SIERRA AVE APT 116
FRESNO CA
93704-1041
US

V. Phone/Fax

Practice location:
  • Phone: 559-645-1727
  • Fax:
Mailing address:
  • Phone: 559-860-3459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: