Provider Demographics
NPI:1215415864
Name:SOLIS-LOZA, PAULINA (ACSW, LMSW)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:SOLIS-LOZA
Suffix:
Gender:F
Credentials:ACSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD SUITE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8707
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 860W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2189
Practice Address - Country:US
Practice Address - Phone:310-301-7396
Practice Address - Fax:310-828-5165
Is Sole Proprietor?:No
Enumeration Date:2018-08-04
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82737101YM0800X
CALCSW943051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health