MEDICARE: JENNA SOLIS

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1821587338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA SOLIS

Provider Business Mailing Address
First Line	:	3701 STOCKER ST
Second Line	:
City	:	VIEW PARK
State	:	CA
Zip	:	90008-5108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 STOCKER ST
Second Line	:
City	:	VIEW PARK
State	:	CA
Zip	:	90008-5108
Country	:	US
Telephone Number	:	818-519-2226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2018
Last Update Date	:	05/10/2018

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Directions to “ JENNA SOLIS ” Practice Location

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