Healthcare Provider Details

I. General information

NPI: 1962829135
Provider Name (Legal Business Name): MRS. JOSEFINA VIANEY SOLORIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 15TH ST STE B
MERCED CA
95341-6217
US

IV. Provider business mailing address

PO BOX 2087
MERCED CA
95344-0087
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-6800
  • Fax: 209-724-4029
Mailing address:
  • Phone: 209-381-6800
  • Fax: 209-725-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW94101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: