Provider Demographics
NPI:1720851900
Name:SOKOLOV, ASHELY CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:ASHELY
Middle Name:CYNTHIA
Last Name:SOKOLOV
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ASHELY
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1293
Mailing Address - Country:US
Mailing Address - Phone:209-598-1081
Mailing Address - Fax:
Practice Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 200
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1293
Practice Address - Country:US
Practice Address - Phone:209-598-1081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA801226163W00000X
CA801126163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse