Provider Demographics
NPI:1265250872
Name:SOLIS LOPEZ, MARIA JOSE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JOSE
Last Name:SOLIS LOPEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:JOSE
Other - Last Name:SOLISJAEGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6510 PINE MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2545
Mailing Address - Country:US
Mailing Address - Phone:209-273-9729
Mailing Address - Fax:
Practice Address - Street 1:1617 SAINT MARKS PLZ
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6455
Practice Address - Country:US
Practice Address - Phone:209-888-6346
Practice Address - Fax:209-478-4939
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist