Individual provider Active NPI

Julie Boutros Soliman

  • Clinical Child & Adolescent Psychologist
  • Loma Linda, CA
National Provider Identifier
1164919247
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
32578 Issued in CA
Practice address
25815 Barton Rd # C102
Loma Linda, CA 92354-3893
Phone
(909) 478-1100
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 32578 CA Primary
Psychologist 103T00000X 32578 CA

Addresses

Primary practice location

25815 Barton Rd # C102
Loma Linda, CA 92354-3893

Mailing address

15957 Butterfly Dr
Fontana, CA 92336-5582
Phone (818) 689-0359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32578CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1164919247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15957 BUTTERFLY DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365582",
            "telephone_number": "818-689-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25815 BARTON RD # C102",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543893",
            "telephone_number": "909-478-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIMAN",
        "first_name": "JULIE",
        "middle_name": "BOUTROS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "32578",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "32578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.