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General NPI Number Information
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NPI Number | 1326554544
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Entity Type | Organization
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Legal Business Name | SOL COMMUNITY AND THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 12/26/2017
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Provider Practice Location Address
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Address Line | 24328 VERMONT AVE STE 224
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City | HARBOR CITY
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State | CA
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Zip | 90710-2317
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Country | US
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Telephone | 310-941-2597
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Fax | 855-882-5621
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Provider Business Mailing Address
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Address Line | 24328 VERMONT AVE STE 224
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City | HARBOR CITY
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State | CA
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Zip | 90710-2317
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Country | US
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Telephone | 310-941-2597
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Fax | 855-882-5621
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SOLEDAD RODRIGUEZ QUEREJAZU
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Credential | THERAPIST
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Telephone | 310-941-2597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8291
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License Number State | CA
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