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General NPI Number Information
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NPI Number | 1043062045
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Entity Type | Individual
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Provider Name | MARYAM SOLTANI
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 4221 WILSHIRE BLVD STE 300A
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City | LOS ANGELES
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State | CA
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Zip | 90010-3537
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Country | US
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Telephone | 888-428-3223
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Fax | 323-866-1881
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Provider Business Mailing Address
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Address Line | 4221 WILSHIRE BLVD STE 300A
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City | LOS ANGELES
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State | CA
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Zip | 90010-3537
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Country | US
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Telephone | 888-428-3223
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Fax | 323-866-1881
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | RBT-25-404205
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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