Healthcare Provider Details

I. General information

NPI: 1144985011
Provider Name (Legal Business Name): CYNTHIA SOLORIO TELLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 PACIFIC COAST HWY STE E #306
TORRANCE CA
90505-7066
US

IV. Provider business mailing address

2785 PACIFIC COAST HWY STE E #306
TORRANCE CA
90505-7066
US

V. Phone/Fax

Practice location:
  • Phone: 310-339-3931
  • Fax:
Mailing address:
  • Phone: 310-339-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: