Individual provider Active NPI

Roberto Solorio Jr., LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1972088185
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
102729 Issued in CA
Practice address
4445 Eastgate Mall Ste 200
San Diego, CA 92121-1979
Phone
(866) 478-3978
NPI assigned
Oct 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CA
Clinical Social Worker 1041C0700X 102729 CA Primary

Addresses

Primary practice location

4445 Eastgate Mall Ste 200
San Diego, CA 92121-1979

Mailing address

2921 S Redondo Blvd Apt 9
Los Angeles, CA 90016-3852
Phone (323) 537-5866

Other practice location 1

150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016004751 CA Practitioner - Clinical Social Worker 8022540939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102729CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Aug 11, 2024 Accepting new patients
Homeless Health Care Los Angeles Past Accepting new patients
San Fernando Community Hospital PastSince Sep 1, 2021 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

4445 Eastgate Mall
Ste 200
San Diego, CA 92121
Phone (844) 724-7365

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1972088185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 S REDONDO BLVD APT 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900163852",
            "telephone_number": "323-537-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "866-478-3978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Valpreda Rd",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "CA",
            "postal_code": "920692973",
            "country_code": "US",
            "telephone_number": "760-736-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLORIO",
        "first_name": "ROBERTO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.