Healthcare Provider Details

I. General information

NPI: 1790144483
Provider Name (Legal Business Name): CATHLEEN JANE PADERES SOLANO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SCOFIELD AVE
WASCO CA
93280-7515
US

IV. Provider business mailing address

8101 CAMINO MEDIA APT 184
BAKERSFIELD CA
93311-2029
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-8400
  • Fax:
Mailing address:
  • Phone: 661-758-8400
  • Fax: 661-758-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW68857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: