Healthcare Provider Details

I. General information

NPI: 1770345688
Provider Name (Legal Business Name): SEPHORA L TOKO CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19470 E 57TH AVE APT 204
AURORA CO
80019-2916
US

IV. Provider business mailing address

19470 E 57TH AVE APT 204
AURORA CO
80019-2916
US

V. Phone/Fax

Practice location:
  • Phone: 303-994-5987
  • Fax:
Mailing address:
  • Phone: 303-994-5987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA.00781804
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: