Provider Demographics
NPI:1992284376
Name:SOKOLIK, MARIE (CN, HHA MA)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SOKOLIK
Suffix:
Gender:F
Credentials:CN, HHA MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83078 SHADOW HILLS WAY
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-3026
Mailing Address - Country:US
Mailing Address - Phone:760-218-8572
Mailing Address - Fax:760-218-8572
Practice Address - Street 1:83078 SHADOW HILLS WAY
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-3026
Practice Address - Country:US
Practice Address - Phone:760-218-8572
Practice Address - Fax:760-218-8572
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7503025335374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide