Provider Demographics
NPI:1598423618
Name:GRAHAM, SOKHA ROCHELLE
Entity Type:Individual
Prefix:MRS
First Name:SOKHA
Middle Name:ROCHELLE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SOKHA
Other - Middle Name:ROCHELLE
Other - Last Name:BRINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:821 SPRING ESTATES AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-3008
Mailing Address - Country:US
Mailing Address - Phone:510-904-1350
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 220A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0850
Practice Address - Country:US
Practice Address - Phone:702-560-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide