Provider Demographics
NPI:1417931692
Name:SOLOMON, ALLAN HOWARD (PHD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:HOWARD
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MT DIABLO BLVD
Mailing Address - Street 2:STE 406
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4890
Mailing Address - Country:US
Mailing Address - Phone:925-943-6572
Mailing Address - Fax:510-230-4752
Practice Address - Street 1:1200 MT DIABLO BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4852
Practice Address - Country:US
Practice Address - Phone:925-943-6572
Practice Address - Fax:925-258-0511
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 6304103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY6304OtherCALIFORNIA LICENSE