Healthcare Provider Details

I. General information

NPI: 1841036167
Provider Name (Legal Business Name): MICHAEL ANDREW SOLORIO ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date: 07/14/2025
Reactivation Date: 08/11/2025

III. Provider practice location address

205 39TH ST
RICHMOND CA
94805-2212
US

IV. Provider business mailing address

1740 ARCH ST
BERKELEY CA
94709-1328
US

V. Phone/Fax

Practice location:
  • Phone: 510-412-5930
  • Fax: 510-412-0567
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW132551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: