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General NPI Number Information
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NPI Number | 1952294183
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Entity Type | Individual
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Provider Name | SOLEDAD VAZQUEZ
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Gender | Female
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1968 S COAST HWY # 2862
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3681
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Country | US
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Telephone | 909-909-1679
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Fax |
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Provider Business Mailing Address
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Address Line | 1157 E CARSON ST APT 5
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City | LONG BEACH
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State | CA
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Zip | 90807-3653
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Country | US
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Telephone | 310-592-6616
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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