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General NPI Number Information
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NPI Number | 1982536850
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Entity Type | Individual
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Provider Name | MARAVEDI CONSUELO SOLORIO REYES
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Gender | Female
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 1005 ATLANTIC AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-1148
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Country | US
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Telephone | 415-474-7310
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Fax |
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Provider Business Mailing Address
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Address Line | 2243 PACIFIC AVE APT C
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City | ALAMEDA
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State | CA
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Zip | 94501-1454
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Country | US
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Telephone | 415-474-7310
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPPS-KRXODH
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License Number State | CA
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