Provider Demographics
NPI:1144622465
Name:SOLIS, YESENIA (OTS)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:OTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3767 1/2 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1817
Mailing Address - Country:US
Mailing Address - Phone:323-316-4069
Mailing Address - Fax:
Practice Address - Street 1:3767 1/2 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-1817
Practice Address - Country:US
Practice Address - Phone:323-316-4069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program