Provider Demographics
NPI:1164015558
Name:SOLANO, OSCAR JOSHUA
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:JOSHUA
Last Name:SOLANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S IVY ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4339
Mailing Address - Country:US
Mailing Address - Phone:951-264-4855
Mailing Address - Fax:
Practice Address - Street 1:401 S IVY ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4339
Practice Address - Country:US
Practice Address - Phone:951-264-4855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician