Provider Demographics
NPI:1811655111
Name:HEREK, SOPHIA COBLE (RBT)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:COBLE
Last Name:HEREK
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:ANNE
Other - Last Name:COBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 PENDEGAST ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4634
Mailing Address - Country:US
Mailing Address - Phone:530-863-5224
Mailing Address - Fax:
Practice Address - Street 1:8912 VOLUNTEER LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3221
Practice Address - Country:US
Practice Address - Phone:916-344-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker