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General NPI Number Information
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NPI Number | 1164919247
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Entity Type | Individual
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Provider Name | JULIE BOUTROS SOLIMAN
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Gender | Female
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Dates
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Enumeration Date | 04/15/2018
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 25815 BARTON RD # C102
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City | LOMA LINDA
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State | CA
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Zip | 92354-3893
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Country | US
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Telephone | 909-478-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 15957 BUTTERFLY DR
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City | FONTANA
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State | CA
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Zip | 92336-5582
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Country | US
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Telephone | 818-689-0359
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Fax |
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 32578
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 32578
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License Number State | CA
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