Healthcare Provider Details

I. General information

NPI: 1437097607
Provider Name (Legal Business Name): VANESSA REYES SOLIS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 7TH ST
WASCO CA
93280-1735
US

IV. Provider business mailing address

1102 HERNANDEZ AVE
MC FARLAND CA
93250-9527
US

V. Phone/Fax

Practice location:
  • Phone: 661-446-4050
  • Fax:
Mailing address:
  • Phone: 661-446-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: