Provider Demographics
NPI:1245755198
Name:CHOUP, SOKRA
Entity Type:Individual
Prefix:
First Name:SOKRA
Middle Name:
Last Name:CHOUP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SIDUS
Other - Middle Name:
Other - Last Name:CHOUP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1301 SHERIDAN AVE APT 79
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2756
Mailing Address - Country:US
Mailing Address - Phone:209-981-8294
Mailing Address - Fax:
Practice Address - Street 1:590 RIO LINDO AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1817
Practice Address - Country:US
Practice Address - Phone:530-345-3491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)