Provider Demographics
NPI:1669294922
Name:HINKS, SOPHI DOLOR (MS SLP)
Entity type:Individual
Prefix:
First Name:SOPHI
Middle Name:DOLOR
Last Name:HINKS
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:SOPHI
Other - Middle Name:DOLOR
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1110 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5587
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:575 MENLO DR STE 2
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3709
Practice Address - Country:US
Practice Address - Phone:916-287-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16987235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist