1194274910 NPI number — ALLAN H. SOLOMON PH.D. INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194274910 NPI number — ALLAN H. SOLOMON PH.D. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLAN H. SOLOMON PH.D. INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194274910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 MT DIABLO BLVD
Provider Second Line Business Mailing Address:
STE. 406
Provider Business Mailing Address City Name:
WALNUT CREEK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94596-4852
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-943-6572
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 MT. DIABLO BLVD.
Provider Second Line Business Practice Location Address:
STE. 406
Provider Business Practice Location Address City Name:
WALNUT CREEK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94596-4890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-943-6572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOLOMON
Authorized Official First Name:
ALLAN
Authorized Official Middle Name:
HOWARD
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
925-943-6572

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY 6304 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)