Provider Demographics
NPI:1033527510
Name:SOULET, IRIS LAU YEE
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:LAU YEE
Last Name:SOULET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAUYEE
Other - Middle Name:
Other - Last Name:PANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1211 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122
Mailing Address - Country:US
Mailing Address - Phone:650-814-9027
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3546
Practice Address - Country:US
Practice Address - Phone:650-814-9027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst