Healthcare Provider Details

I. General information

NPI: 1003439647
Provider Name (Legal Business Name): SERENA SOLORZANO BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ESSEX ST
SAN FRANCISCO CA
94105-3195
US

IV. Provider business mailing address

365 FULTON ST
SAN FRANCISCO CA
94102-4489
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax: 415-447-9805
Mailing address:
  • Phone: 415-474-7310
  • Fax: 415-447-9805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: