Provider Demographics
NPI:1841472289
Name:SERRANO-SOLIS, ANGELICA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:MICHELLE
Last Name:SERRANO-SOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 RIVERSIDE DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4536
Mailing Address - Country:US
Mailing Address - Phone:909-590-5355
Mailing Address - Fax:
Practice Address - Street 1:6180 RIVERSIDE DR
Practice Address - Street 2:SUITE H
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4536
Practice Address - Country:US
Practice Address - Phone:909-590-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional