Provider Demographics
NPI:1801005756
Name:SOLEIMANY, SOHEYLA (MFT)
Entity Type:Individual
Prefix:MS
First Name:SOHEYLA
Middle Name:
Last Name:SOLEIMANY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ELLA
Other - Middle Name:
Other - Last Name:SOLEIMANY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:PO BOX 14957
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-4957
Mailing Address - Country:US
Mailing Address - Phone:805-801-3552
Mailing Address - Fax:
Practice Address - Street 1:1460 HIGUERA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2962
Practice Address - Country:US
Practice Address - Phone:805-801-3552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44071106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist