MEDICARE: SOLIVERA INTEGRATIVE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1629912498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLIVERA INTEGRATIVE CLINIC

Provider Business Mailing Address
First Line	:	7851 RAINCROSS CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-0011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7851 RAINCROSS CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-0011
Country	:	US
Telephone Number	:	949-384-7794
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YOHANNA BERHANU
Credential	:
Telephone Number	:	949-384-7794

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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