Provider Demographics
NPI:1083181168
Name:CORTEZ, SOL QUILAZTLI
Entity Type:Individual
Prefix:MRS
First Name:SOL
Middle Name:QUILAZTLI
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-7038
Mailing Address - Country:US
Mailing Address - Phone:559-392-8234
Mailing Address - Fax:
Practice Address - Street 1:216 E CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-7038
Practice Address - Country:US
Practice Address - Phone:559-392-8234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician