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General NPI Number Information
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NPI Number | 1205798766
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Entity Type | Individual
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Provider Name | SAMANTHA GRACE SOLTERO
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 17752 SKY PARK CIR STE 140
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City | IRVINE
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State | CA
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Zip | 92614-4469
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Country | US
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Telephone | 949-474-5577
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Fax | 949-475-5577
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Provider Business Mailing Address
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Address Line | 21000 ARROYO DR. #22330
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City | IRVINE
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State | CA
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Zip | 92617
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Country | US
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Telephone | 619-921-0967
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1475090
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License Number State | CA
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