1568695856 NPI number — MS. KATHERINE SOLIS RD, MA, CDE

Table of content: MS. KATHERINE SOLIS RD, MA, CDE (NPI 1568695856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568695856 NPI number — MS. KATHERINE SOLIS RD, MA, CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLIS
Provider First Name:
KATHERINE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RD, MA, CDE
Provider Gender Code:
F

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:
1568695856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2350 W EL CAMINO REAL
Provider Second Line Business Mailing Address:
FL 2
Provider Business Mailing Address City Name:
MOUNTAIN VIEW
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94040-6203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-600-0110
Provider Business Mailing Address Fax Number:
415-558-7038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 SACRAMENTO ST FL 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94118-1625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-600-2651
Provider Business Practice Location Address Fax Number:
415-600-6279
Provider Enumeration Date:
09/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  722664 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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