Provider Demographics
NPI:1871624049
Name:SOLMAYOR, PAUL (MSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SOLMAYOR
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N GRAND AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1001
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:626-974-8114
Practice Address - Street 1:1411 N GRAND AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1001
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:626-974-8114
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97091101YM0800X, 104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health