Provider Demographics
NPI:1770935249
Name:SOLORZANO, EVELYN ROSE (LMFT, APCC)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:ROSE
Last Name:SOLORZANO
Suffix:
Gender:F
Credentials:LMFT, APCC
Other - Prefix:MS
Other - First Name:EVELYN
Other - Middle Name:ROSE
Other - Last Name:VELASCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1968 S COAST HWY # 1333
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3681
Mailing Address - Country:US
Mailing Address - Phone:916-300-7700
Mailing Address - Fax:
Practice Address - Street 1:1544 EUREKA RD STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3092
Practice Address - Country:US
Practice Address - Phone:916-797-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4359101YP2500X
CA110962106H00000X
172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172M00000XOther Service ProvidersMechanotherapist