Basic Information
| Provider Information | |||||||||
| NPI: | 1144874512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLIS | ||||||||
| FirstName: | ANDREA | ||||||||
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| Credential: | AMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3410 LA SIERRA AVE # F326 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925035270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512314398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1812 W PARK AVE | ||||||||
| Address2: | |||||||||
| City: | REDLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923738014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9097480259 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2019 | ||||||||
| LastUpdateDate: | 03/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | AMFT122046 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.