Provider Demographics
NPI:1326554544
Name:SOL COMMUNITY AND THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:SOL COMMUNITY AND THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOLEDAD
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:QUEREJAZU
Authorized Official - Suffix:
Authorized Official - Credentials:THERAPIST
Authorized Official - Phone:310-941-2597
Mailing Address - Street 1:24328 VERMONT AVE STE 224
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2317
Mailing Address - Country:US
Mailing Address - Phone:310-941-2597
Mailing Address - Fax:855-882-5621
Practice Address - Street 1:24328 VERMONT AVE STE 224
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2317
Practice Address - Country:US
Practice Address - Phone:310-941-2597
Practice Address - Fax:855-882-5621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty