Basic Information
| Provider Information | |||||||||
| NPI: | 1144603465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLA-NEGRON | ||||||||
| FirstName: | SOLYMAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5128 MISSION ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941123422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157694500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5128 MISSION ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157694500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2015 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 106H00000X | IMF98826 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.