Provider Demographics
NPI:1750633772
Name:PERALES-SOLIS, EVELYN GUADALUPE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:GUADALUPE
Last Name:PERALES-SOLIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:14445 OLIVE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1438
Mailing Address - Country:US
Mailing Address - Phone:818-983-9471
Mailing Address - Fax:747-210-4239
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1438
Practice Address - Country:US
Practice Address - Phone:747-210-4248
Practice Address - Fax:747-210-4239
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCSW919791041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program