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General NPI Number Information
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NPI Number | 1891451332
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Entity Type | Individual
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Provider Name | IXCHEL CAROLINA SOLORZANO M.A.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 7734 HERSCHEL AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-4433
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Country | US
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Telephone | 858-568-7803
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Fax |
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Provider Business Mailing Address
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Address Line | 2952 WORDEN ST
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City | SAN DIEGO
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State | CA
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Zip | 92110-5708
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Country | US
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Telephone | 408-529-9784
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 128774
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License Number State | CA
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