Individual provider Active NPI

Lily Colleen Solodovnikov, MSW

  • Social Worker
  • San Luis Obispo, CA
National Provider Identifier
1083405559
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW130994 Issued in CA
Practice address
1255 Kendall Rd
San Luis Obispo, CA 93401-8750
Phone
(805) 781-3535
NPI assigned
May 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Social Worker 104100000X ASW130994 CA Primary

Addresses

Primary practice location

1255 Kendall Rd
San Luis Obispo, CA 93401-8750

Mailing address

249 Aspen St
Arroyo Grande, CA 93420-3074
Phone (805) 889-2189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW130994CAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1083405559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 ASPEN ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203074",
            "telephone_number": "805-889-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 KENDALL RD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018750",
            "telephone_number": "805-781-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLODOVNIKOV",
        "first_name": "LILY",
        "middle_name": "COLLEEN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW130994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.