Healthcare Provider Details

I. General information

NPI: 1235858754
Provider Name (Legal Business Name): FRANCE FIDELIS SOLLER SOLANZO OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BERN CT STE 140
SAN JOSE CA
95112-1242
US

IV. Provider business mailing address

591 BELLWOOD DR
SANTA CLARA CA
95054-2106
US

V. Phone/Fax

Practice location:
  • Phone: 408-573-7720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number24021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: