Healthcare Provider Details
I. General information
NPI: 1003059221
Provider Name (Legal Business Name): ESMERALDA SOLORZANO CHRISTENSEN MFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/17/2009
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5100 MARLBOROUGH DR
SAN DIEGO CA
92116-2020
US
IV. Provider business mailing address
5100 MARLBOROUGH DR
SAN DIEGO CA
92116-2020
US
V. Phone/Fax
- Phone: 619-567-7399
- Fax: 619-567-7399
- Phone: 619-567-7399
- Fax: 619-567-7399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPCC 1568 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFC 45349 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: