Provider Demographics
NPI:1578121752
Name:SOKA, EUNICE J
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:J
Last Name:SOKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 HOWARD AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2631
Mailing Address - Country:US
Mailing Address - Phone:703-462-9141
Mailing Address - Fax:703-462-9142
Practice Address - Street 1:1880 HOWARD AVE STE 307
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2631
Practice Address - Country:US
Practice Address - Phone:703-462-9141
Practice Address - Fax:703-462-9142
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-2088385H00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385H00000XRespite Care FacilityRespite Care