Healthcare Provider Details

I. General information

NPI: 1992284376
Provider Name (Legal Business Name): MARIE SOKOLIK CN, HHA. MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83078 SHADOW HILLS WAY
INDIO CA
92203-3026
US

IV. Provider business mailing address

83078 SHADOW HILLS WAY
INDIO CA
92203-3026
US

V. Phone/Fax

Practice location:
  • Phone: 760-218-8572
  • Fax: 760-218-8572
Mailing address:
  • Phone: 760-218-8572
  • Fax: 760-218-8572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number7503025335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: