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General NPI Number Information
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NPI Number | 1205449832
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Entity Type | Individual
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Provider Name | AUTUMN SOLIS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 215 W JANSS RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1847
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Country | US
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Telephone | 805-370-4435
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Fax |
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Provider Business Mailing Address
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Address Line | 24843 PASEO DEL RANCHO
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City | CALABASAS
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State | CA
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Zip | 91302-3084
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Country | US
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Telephone | 818-599-1177
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 95015145
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License Number State | CA
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