| Doctor Name: | DR. JERRY SOLOMON |
| NPI Number: | 1023142890 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | JERRY SOLOMON |
| License Number: | PSY7825 |
| Business Practice Address: | 407 Avalon St Santa Cruz, CA - 950602207 |
| Business Phone Number: | 8314258785 |
| Business Fax Number: | 8314252308 |
| Mailing Address: | 407 Avalon St, SANTA CRUZ |
| State: | CA |
| Postal Code: | 950602207 |
| Phone Number: | 8314258785 |
| Fax Number: | 8314252308 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY7825 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |